Spinal arteriovenous malformation

Discussion:

Spinal arteriovenous malformations (AVMs) are characterized by arteriovenous shunting with or without a true nidus, and includes both arteriovenous fistulae and arteriovenous malformations.

Spinal AVM's may be classified as intramedullary and extramedullary (80%).

An accurate diagnosis is important because these lesions may represent a reversible cause of myelopathy.

If a spinal vascular malformation is still suspected, digital subtraction angiography (DSA) must be performed to display the very small vessels of the spinal cord. Owing to the complications involved with DSA, an MRA or CTA can be used to determine the spinal cord level of the feeding artery and thus limit the amount of time it takes to perform the DSA procedure.

The present surgical treatment options include open surgical ligation or resection of the malformation, endovascular occlusion, spinal radiation, or a combination of these techniques.

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