Comparison between Spinal Dural Arteriovenous Fistula and Spinal Epidural Arteriovenous Fistula

Abstract

Objective: The purpose of this study is to retrospectively assess the differences between spinal dural arteriovenous fistulas (SDAVFs) and spinal epidural arteriovenous fistulas (SEAVFs). Methods: Subjects consisted of 18 patients with SDAVFs and 7 with SEAVFs admitted to our department between January 2007 and December 2017 exhibiting intradural drainage of shunt flow. Patient background, lesion characteristics, and treatment/follow-up results were compared. Results: Of the seven patients in the SEAVF group, six patients (86%) had been misdiagnosed with SDAVFs at the time of treatment. The rates of patients with a history of spinal surgery, lumbar vertebral lesions, involvement of a dorsal somatic branch (DSB), involvement of multiple segmental arteries, or involvement of bilateral segmental arteries were significantly higher in the SEAVF group. As for post-treatment course, there were significant difference in the recurrence rate after endovascular treatment (SDAVF group: 6%, SEAVF group: 50%, respectively, p < 0.05). Conclusion: Endovascular treatment may not be effective for SEAVFs if they are misdiagnosed as SDAVFs, and they may recur. For optimal treatment, accurate assessment of the angioarchitecture with the latest diagnostic imaging method may be necessary.