MAA Salek1,*, MS Rana,2 MM Hasan,2 AH Manik,1 MS Islam2
1Department of Neurosurgery, Combined Military Hospital Dhaka
2Department of Neurosurgery, Dhaka Medical Hospital
*Corresponding Author: Md Al Amin Salek, MBBS, MCPS, FCPS, MRCS, Combined Military Hospital Dhaka, Dhaka; Email: [email protected]
Received Date: January 17, 2023
Publication Date: March 23, 2023
Citation: Salek MAA, et al. (2023). Spinal Dural Arteriovenous Fistulas: Surgical Outcome Analysis of Twenty Cases. Neuro Research. 5(1):16.
Copyright: Salek MAA, et al. © (2023).
Background: Spinal dural arteriovenous fistulas (SDAVFs) are rare complex spinal vascular shunts, which can inevitably lead to severe disability if remain untreated. Methods: Retrospective analysis of SDAVF patients in a period of three years (2019 to 2021) who presented with progressive paraparesis, bladder symptoms, and/or sensory disturbances. They were evaluated by MRI and localization of the fistula was done by spinal catheter angiogram. Spinal AV fistulas were simply classified as extradural and intradural. They all underwent microsurgical shunt interruption. Neurological function was evaluated by Aminoff-Logue Scale (ALS). Individual ALS scores of each patient (pretreatment and post-treatment) were recorded to find out the p-value of the surgical intervention. Results: A total of 20 patients (mean age 35 ± 10 years, 16 (80.0%) are male. The mean interval from onset to diagnosis was 6 ± 3 months. Among the anatomical location of fistulas, 1(05.0%) was cervical, 16 (80.0%) were in thoracic, and 3 (15.0%) were lumbar. Among the angiographic types of fistulas, 18(90.0%) were intradural and, 2 (10.0%) were extradural. Compared with pre-operative ALS scores,15 (75.00%) patients received improvement, and 05 (25.00%) patients felt worse or more stable. Among 20 surgical procedures, there were complications in three cases (15%): epidural hematoma in 1 case, cerebrospinal fluid leakage in 1 case, and postoperative wound infection in 1 case. Conclusions: In our study, microsurgical interruption of timely diagnosed SDAVF showed good and stable results over time.
Keywords: Spinal dural arteriovenous fistula, spinal catheter angiogram