Endovascular and surgical treatment of a metameric spinal arteriovenous malformation.

Metameric spinal arteriovenous malformations (AVMs) refer to the lesions completely outside of the spinal cord and the surrounding dura. This paper presents an unusual metameric spinal AVM that was fed by multiple radiculomeningeal arteries and was located totally within the extradural space and the vertebral bodies. The metameric spinal AVM has an exclusive epidural venous drainage and presents as a distinct mass from the dural and the intradural spinal AVMs. Total removal of metameric spinal AVMs are sometimes difficult because of wide extension, profound bleeding, and spinal instability after resection. Therefore, the basic management strategy for these lesions is preoperative arterial or venous embolization and resection.