Clinical and Imaging Features of Spinal Dural Arteriovenous Fistula: Clinical Experience of 15 Years for a Major Tertiary Hospital
| Autor: | Hailing Zhang, Xiaoying Bi, Qiang Li, Cunxiu Fan, Jianmin Liu, Yi Xu, Xiaoyan Lu, Meng Liang, Bingying Du |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty Fistula medicine.medical_treatment Arteriovenous fistula Subgroup analysis Neurosurgical Procedures Spinal Cord Diseases Tertiary Care Centers 03 medical and health sciences 0302 clinical medicine medicine Humans Embolization Ligation Aged Retrospective Studies Central Nervous System Vascular Malformations medicine.diagnostic_test business.industry Vascular malformation Magnetic resonance imaging Recovery of Function Odds ratio Middle Aged medicine.disease Spinal cord Embolization Therapeutic Surgery Treatment Outcome medicine.anatomical_structure 030220 oncology & carcinogenesis Female Neurology (clinical) business 030217 neurology & neurosurgery |
| Zdroj: | World Neurosurgery. 138:e177-e182 |
| ISSN: | 1878-8750 |
| Popis: | Background Spinal dural arteriovenous fistula (SDAVF) is a rare spinal vascular malformation which can cause permanent neurologic dysfunction. The purpose of this study was to investigate the relationship between the clinical and imaging characteristics of SDAF and its prognosis. Methods All patients diagnosed with SDAVF and hospitalized in our hospital from February 2004 to September 2018 were retrospectively recruited. The clinical and imaging data of these patients were collected, and then a subgroup analysis was performed to find the association between clinical and imaging characteristics of SDAF and its prognosis. Results A total of 79 patients were included in the analysis. The median age of the patients was 59 years, with men having a predominant morbidity (84.4%). The mean duration of symptoms was 7 months, and most patients had more than 2 symptoms before hospitalization (n = 43, 44.4%). The fistula mainly occurred in the lower thoracic spine (n = 40, 50.6%), followed by the lumbar spine (n = 18, 22.8%) and upper thoracic spine (n = 16, 20.3%). Of 58 patients with magnetic resonance images available, 45 (77.6%) were identified with high T2-weighted image (T2WI) signal in the spinal cord, and 51 (87.9%) with T2WI flow voids on the spinal surface. Multivariate logistic regression analysis found that preoperative Aminoff-Logue Scale (ALS) scores were associated with postoperative function improvement after adjustment for sex, age, and duration of symptoms (P = 0.013; odds ratio, 1.375; 95% confidence interval, 1.07–1.77). Conclusions Preoperative ALS scores are associated with improved prognosis in patients with SDAVF. Both surgical ligation and endovascular embolization can improve functional outcomes and delay disease progression. |
| Databáze: | OpenAIRE |
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