title: Clinical results after the multidisciplinary treatment of spinal arteriovenous fistulas.
abstract: OBJECTIVE
  We retrospectively evaluated the clinical outcome after multidisciplinary treatment of spinal arteriovenous fistulas (AVFs) in terms of the Aminoff-Logue grading scale (ALS) to depict the outcome in a perspective pertinent to the quality of everyday living.
  
  
  METHODS
  Twenty-six spinal AVFs in 25 patients were angiographically diagnosed from April 1998 through April 2012 and treated by endovascular embolization or surgery. When both treatment procedures seemed feasible, embolization was undertaken as the initial treatment. Motor and gait disturbance at follow-up was retrospectively graded according to ALS.
  
  
  RESULTS
  All lesions were localized at the thoracolumbar or sacral levels and include six epidural AVFs with intradural venous reflux, 14 dural AVFs, and six perimedullary AVFs. Embolization was performed as the initial treatment for 17 lesions, while open surgery was performed for the others as well as for residual or recurrent lesions after embolization. All lesions were completely occluded except three perimedullary AVFs. At clinical follow-up of 1-153 months (mean 53.3), amelioration of gait disturbance with reduction of ALS scores was noted for 13 lesions and amelioration of micturition for 13 lesions as well.
  
  
  CONCLUSIONS
  Clinical functional status was improved for half of the lesions after the multidisciplinary treatment.
authors.affiliation: Department of Radiology, Niigata University Medical and Dental Hospital, Asahimachi-dori 1-757, Chuo-ku, Niigata, 951-8510, Japan. sinagawa@med.niigata-u.ac.jp
authors.forename: Shoichi
authors.initials: S
authors.lastname: Inagawa
authors.forename: Shuhei
authors.initials: S
authors.lastname: Yamashita
authors.forename: Hisaya
authors.initials: H
authors.lastname: Hiramatsu
authors.forename: Mika
authors.initials: M
authors.lastname: Kamiya
authors.forename: Tokutaro
authors.initials: T
authors.lastname: Tanaka
authors.forename: Harumi
authors.initials: H
authors.lastname: Sakahara
authors.forename: Hidefumi
authors.initials: H
authors.lastname: Aoyama
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography / Q000379:methods*; D001164:Arteriovenous Fistula / Q000000981:diagnostic imaging* / Q000628:therapy*; D020785:Central Nervous System Vascular Malformations / Q000000981:diagnostic imaging* / Q000628:therapy*; D004621:Embolization, Therapeutic; D005260:Female; D020233:Gait Disorders, Neurologic / Q000145:classification; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome