title: Microscope-assisted endoscopic interlaminar ligation of spinal arteriovenous fistulas: technical note.
abstract: Spinal dural arteriovenous fistulas (SDAVFs) are the most common type of spinal arteriovenous malformations, and microsurgical ligation is the treatment modality most frequently used for these lesions. Developments in endoscopic techniques have made endoscopy an even less invasive alternative to routine microsurgical approaches in spine surgery, but endoscopic management of SDAVF or other intradural spinal lesions has not been reported to date. The authors describe the use of a microscope-assisted endoscopic interlaminar approach for the ligation of the proximal draining vein of an L-1 SDAVF in a 58-year-old man. A complete cure was confirmed by postoperative angiography. The postoperative course was uneventful, and short-term follow-up showed improvements in the patient's neurological function. The authors conclude that the endoscopic interlaminar approach with microscope assistance is a safe, minimally invasive, innovative technique for the surgical management of SDAVFs in selected patients.
authors.affiliation: Department of Neurosurgery, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou;
authors.forename: Chen
authors.initials: C
authors.lastname: Wang
authors.affiliation: Division of Neurosurgery, Department of Surgery, Changhua Christian Hospital, Changhua, Taiwan.
authors.forename: Chien-Min
authors.initials: CM
authors.lastname: Chen
authors.affiliation: Department of Neurosurgery, Ningbo No. 2 Hospital, Ningbo, China; and.
authors.forename: Fang
authors.initials: F
authors.lastname: Shen
authors.affiliation: Department of Neurosurgery, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou;
authors.forename: Xiao-Dong
authors.initials: XD
authors.lastname: Fang
authors.affiliation: Department of Neurosurgery, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou;
authors.forename: Guang-Yu
authors.initials: GY
authors.lastname: Ying
authors.affiliation: Department of Neurosurgery, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou;
authors.forename: Yu-Cheng
authors.initials: YC
authors.lastname: Ren
authors.affiliation: Department of Neurosurgery, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou;
authors.forename: Dan-Feng
authors.initials: DF
authors.lastname: Yu
authors.affiliation: Department of Neurosurgery, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou;
authors.forename: Liang-Liang
authors.initials: LL
authors.lastname: Zhu
authors.affiliation: Department of Neurosurgery, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou;
authors.forename: Yong-Jian
authors.initials: YJ
authors.lastname: Zhu
authors.affiliation: Department of Neurosurgery, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou;
authors.forename: Jian-Min
authors.initials: JM
authors.lastname: Zhang
mesh_terms: D000792:Angiography; D020785:Central Nervous System Vascular Malformations / Q000000981:diagnostic imaging* / Q000601:surgery*; D004724:Endoscopy / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D008026:Ligation / Q000379:methods; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging; D008297:Male; D008853:Microscopy / Q000379:methods*; D008875:Middle Aged; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging; D016896:Treatment Outcome; D014741:Video Recording
keywords: DSA = digital subtraction angiography; MRC = Medical Research Council; SDAVF = spinal dural arteriovenous fistula; VRT = volume-rendering technique; endoscope; interlaminar approach; microscope assistance; spinal dural arteriovenous fistula; technique