title: [Microsurgical management and outcomes of intramedullary spinal arteriovenous malformations: a report of 14 cases].
abstract: Objective:To investigate the clinical features, microsurgical management and outcomes of intramedullary spinal arteriovenous malformations (AVM).Methods:A series of 14 patients (10 male, 4 female; mean age (39.1±17.2) years ranged from 16 to 72 years) with intramedullary spinal AVM who underwent microsurgical treatment from November 2008 to April 2015 in Department of Neurosurgery at Beijing Tiantan Hospital were retrospectively reviewed. The location of the AVM included cervical (n=6), thoracic (n=3), cervicothoracic (n=2), and conus medullaris (n=3). The patients underwent microsurgery via the posterior myelotomy, indocyanine green fluorescence angiography(ICG)was performed to detect the feeding arteries and draining veins. After the lesions were removed, ICG was performed again to judge whether the AVM was resected completely.Results:Fourteen patients underwent resection of intramedullary spinal AVM in this period, total AVM resection was achieved in 12 patients and subtotal in 2 patients. The amount of bleeding was (178.6±141.0) ml ranged from 100 to 600 ml intraoperatively and no one received blood transfusion. Clinically, 13 patients improved, 1 patient worsened. Twelve patients got functionally improved, 2 patients remained unchanged during the long-term follow-up period ranged from 11 to 84 months, with a mean time of (60.9±20.4) months.Conclusions:Intramedullary spinal AVM is an extremely rare spinal vascular disease. Microsurgical treatment can safely resect the lesions with satisfactory clinical outcomes and reduce spine function deterioration.
authors.affiliation: Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China.
authors.forename: L
authors.initials: L
authors.lastname: Zhang
authors.forename: W Q
authors.initials: WQ
authors.lastname: Jia
authors.forename: J
authors.initials: J
authors.lastname: Yang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000792:Angiography; D001165:Arteriovenous Malformations / Q000601:surgery*; D005260:Female; D006470:Hemorrhage; D006801:Humans; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D019635:Neurosurgical Procedures; D012189:Retrospective Studies; D013116:Spinal Cord / Q000601:surgery*; D013131:Spine; D016896:Treatment Outcome; D055815:Young Adult