Surgical treatment and outcome of spinal arteriovenous malformations.

Abstract

Aim: A rare and diverse set of abnormalities formed by spinal blood arteries known as spinal arteriovenous malformations (AVMs) has a higher risk of hemorrhage and morbidity, causing the shunting of blood from veins with an aberrant capillary bed to arteries. Knowledge of the vascular anatomy of spinal AVMs and the spinal cord's vascular supply is crucial to its therapy. The aim of this study was to report a case of SAVM healing after surgical excision, highlighting the importance of surgical excision in treating these rare lesions.

Methods: A 56-year-old male with progressive bilateral lower extremity weakness and numbness was diagnosed with spinal cord arteriovenous malformation (SAVM). A thoracolumbar spine MRI was performed, and a vascular lesion was found. The feeding artery was coagulated and incised, and the surrounding hematoma was removed. Spinal cord arteriovenous malformation was diagnosed postoperatively. The Oswestry Disability Index (ODI) and the SF-36 questionnaires assessed functional outcomes and physical functioning in individuals with acute or chronic low back pain.

Results: In the reported case, the aneurysm showed spontaneous regression at follow-up after surgical removal of the AVM. Post-surgery rehabilitation improved his motor function. After seven months, he showed 90% physical functioning, 75% emotional well-being, 75% social functioning, 87.5% pain, and 55% general health. He could walk with a walking aid and perform daily activities.

Conclusion: Treatment strategies for AVM-related spinal aneurysms should be carefully considered. Surgical treatment in several conditions has advantages and is reported to have good outcomes.