[Surgical treatment of spinal dural arteriovenous fistulas].
OBJECTIVE
To discuss the operation modalities of spinal dural arteriovenous fistulae (SDAVFs) and treatment with anticoagulant agents after surgery.


METHODS
The medical records, radiographic studies and operations of 23 patients with SDAVFs were reviewed. Laminectomy was performed at the level of the arterialized venous entry into the subarachnoid space in 18 patients with thoracic and lumbar lever AVFs, followed by coagulation, clipping and division of the vein. In 14 of 18 patients, the arteriovenous nidus in the dura was identified and obliterated by coagulation. The draining veins were interrupted at L(5) - S(1) level in 5 patients with sacral AVFs. Anticoagulant treatment was given in 13 patients.


RESULTS
Outcome was good in 20 patients and 2 of the 20 had transient postoperative neurological deterioration that reversed by anticoagulant agents. No changes were seen in 2 patients except one deteriorated.


CONCLUSIONS
Surgical interruption of arterialized radicular-medullary draining vein of SDAVFs provides lasting occlusion of the fistula, and postoperative anticoagulant therapy can prevent thrombosis of the coronal venous plexus.
Zhi
X
X
Interventional Neuroradiology Center, Beijing Hospital, Beijing 100730.
Ling
F
F
Wang
D
D
Li
M
M
Zhang
H
H
Song
Q
Q
Qu
H
H
D000328:Adult; D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use; D001164:Arteriovenous Fistula / Q000601:surgery*; D004388:Dura Mater / Q000098:blood supply*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control; D013116:Spinal Cord / Q000098:blood supply*; D013927:Thrombosis / Q000517:prevention & control; D016896:Treatment Outcome
D000925:Anticoagulants