Surgical and endovascular treatment for spinal arteriovenous malformations

Toshiki Endo, Hidenori Endo, Kenichi Sato, Yasushi Matsumoto, Teiji Tominaga

Research output: Contribution to journalReview article

11 Citations (Scopus)

Abstract

Spinal arteriovenous malformation (AVM) is a broad term that constitutes diverse vascular pathologies. To date, various classification schemes for spinal AVM have been proposed in literature, which helped neurosurgeons understand the pathophysiology of the disease and determine an optimal treatment strategy. To discuss indications and results of surgical and endovascular interventions for spinal AVM, this article refers to the following classification proposed by Anson and Spetzler in 1992: type I, dural arteriovenous fistula (AVF); type II, glomus intramedullary AVM; type III, juvenile malformations; and type IV, perimedullary AVF. In general, complete obliteration of the fistula is a key for better outcome in type I dural and type IV perimedullary AVFs. On the other hand, in type II glomus and type III juvenile malformations, functional preservation, instead of pursuing angiographical cure, is the main goal of the treatment. In such cases, reduction of the shunt flow can alleviate clinical symptoms. Proper management of spinal AVM should start with neurological examination and understanding of angioarchitectures, which provide critical information that guides the indication and modality of intervention. Finally, close collaboration of the microsurgical and endovascular teams are mandatory for successful treatment.

Original languageEnglish
Pages (from-to)457-464
Number of pages8
JournalNeurologia medico-chirurgica
Volume56
Issue number8
DOIs
Publication statusPublished - 2016

Keywords

  • Arteriovenous malformation
  • Endovascular treatment
  • Spinal cord
  • Surgery

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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