Diagnosis and surgical treatment of spinal dural arteriovenous fi stula

Objective To explore the diagnosis and treatment of spinal dural arteriovenous fi stula. Methods From January 2009 to December 2017, clinical data about 9 patients with spinal dural arteriovenous fi stula treated in the 306th Hospital of PLA were retrospectively analyzed. Of the 9 cases, there were 8 males and 1 female with the age of 33-68 years old. The patients admitted to hospital due to sensation, motor dysfunction of lower extremities, or urinary excretion dysfunction. After MRI and DSA examinations, spinal dural arteriovenous fi stula were diagnosed. Six patients underwent microsurgery and 3 underwent interventional embolization. Results Because of insufficient knowledge of the disease, 7 out of 9 cases were misdiagnosed in other hospitals. The diagnosis of the disease was confirmed by myelography in our hospital. On T2-weighted images, high-intensity areas across multiple segments of the spinal cord combined with signal fl ow voids around spinal cord indicated that the fi stula located in the thoracic segment, while the serpentine fl ow voids in the lumbosacral canal indicated that the fi stula located in the lumbar segment. All patients underwent surgical clipping of fi stula or interventional embolization, and some patients' symptoms were relieved. Conclusion Spinal dural arteriovenous fi stula is frequently misdiagnosed due to insufficient knowledge of this disease, thus the course of disease is prolonged. Full recognition of MRI is beneficial to the early diagnosis of the disease which has positive significance for the recovery of neurological function imparment.