Ji Eun Park1, Hae-Won Koo2, Hairi Liu3, Seung Chul Jung1, Danbi Park1, Dae Chul Suh4. 1. Departments of Radiology, University of Ulsan, 88, Olympic-ro 43-gil, 138-736, Seoul, Songpa-gu, Korea. 2. Department of Neurosurgery, Ilsan Paik Hospital, College of Medicine, Inje University, Goyang, Korea. 3. Department of Interventional Radiology, Taizhou People's Hospital, 225300, Taizhou, Jiangsu Province, P. R. China. 4. Departments of Radiology, University of Ulsan, 88, Olympic-ro 43-gil, 138-736, Seoul, Songpa-gu, Korea. dcsuh@amc.seoul.kr.
Abstract
PURPOSE: Spinal arteriovenous malformations (SAVMs) are rare events. This study evaluated initial clinical presentations and treatment outcomes of SAVMs. METHODS: In this study, 91 consecutive patients with SAVM between January 1993 and November 2014 were evaluated. Initial clinical presentations, radiological findings, treatment results, and follow-up outcomes were evaluated according to disease type and treatment modalities. Patient status was scored using the modified Rankin scale (mRS) and Aminoff-Logue Disability scale (ALS). RESULTS: Of the SAVM patients 69 % were male and 31 % were female with a mean age of 49 years (range 11-82 years). At the time of initial imaging evaluation, myelopathy was the most common finding with main complaints of gait disturbance (69 out of 91, 76 %), sensory disturbances (61/91, 67 %), and bowel or bladder symptoms (51/91, 56 %). Among the 80 patients who received treatment 56 (62 %) underwent endovascular embolization and 24 (26 %) underwent surgery. Complete obliteration was achieved in 47 patients (84 %) after endovascular embolization and in 18 (75 %) after surgical ligation. At the time of final follow-up 67 patients (84 %) showed improvement of more than 1 point on the mRS, while 69 (86 %) showed significant improvement on the ALS after treatment. CONCLUSION: The SAVMs presented with diverse neurological deficits, including myelopathy. Endovascular or surgical treatment of SAVMs can result in good clinical outcomes in most patients.
PURPOSE:Spinal arteriovenous malformations (SAVMs) are rare events. This study evaluated initial clinical presentations and treatment outcomes of SAVMs. METHODS: In this study, 91 consecutive patients with SAVM between January 1993 and November 2014 were evaluated. Initial clinical presentations, radiological findings, treatment results, and follow-up outcomes were evaluated according to disease type and treatment modalities. Patient status was scored using the modified Rankin scale (mRS) and Aminoff-Logue Disability scale (ALS). RESULTS: Of the SAVM patients 69 % were male and 31 % were female with a mean age of 49 years (range 11-82 years). At the time of initial imaging evaluation, myelopathy was the most common finding with main complaints of gait disturbance (69 out of 91, 76 %), sensory disturbances (61/91, 67 %), and bowel or bladder symptoms (51/91, 56 %). Among the 80 patients who received treatment 56 (62 %) underwent endovascular embolization and 24 (26 %) underwent surgery. Complete obliteration was achieved in 47 patients (84 %) after endovascular embolization and in 18 (75 %) after surgical ligation. At the time of final follow-up 67 patients (84 %) showed improvement of more than 1 point on the mRS, while 69 (86 %) showed significant improvement on the ALS after treatment. CONCLUSION: The SAVMs presented with diverse neurological deficits, including myelopathy. Endovascular or surgical treatment of SAVMs can result in good clinical outcomes in most patients.
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