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Clinical Characteristics and Treatment Outcomes of Spinal Arteriovenous Malformations

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Abstract

Purpose

Spinal arteriovenous malformations (SAVMs) are rare events. This study evaluated initial clinical presentations and treatment outcomes of SAVMs.

Methods

In this study, 91 consecutive patients with SAVM between January 1993 and November 2014 were evaluated. Initial clinical presentations, radiological findings, treatment results, and follow-up outcomes were evaluated according to disease type and treatment modalities. Patient status was scored using the modified Rankin scale (mRS) and Aminoff–Logue Disability scale (ALS).

Results

Of the SAVM patients 69 % were male and 31 % were female with a mean age of 49 years (range 11–82 years). At the time of initial imaging evaluation, myelopathy was the most common finding with main complaints of gait disturbance (69 out of 91, 76 %), sensory disturbances (61/91, 67 %), and bowel or bladder symptoms (51/91, 56 %). Among the 80 patients who received treatment 56 (62 %) underwent endovascular embolization and 24 (26 %) underwent surgery. Complete obliteration was achieved in 47 patients (84 %) after endovascular embolization and in 18 (75 %) after surgical ligation. At the time of final follow-up 67 patients (84 %) showed improvement of more than 1 point on the mRS, while 69 (86 %) showed significant improvement on the ALS after treatment.

Conclusion

The SAVMs presented with diverse neurological deficits, including myelopathy. Endovascular or surgical treatment of SAVMs can result in good clinical outcomes in most patients.

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Funding

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Departments of Radiology, University of Ulsan, 88, Olympic-ro 43-gil, 138-736, Seoul, Songpa-gu, Korea

    Ji Eun Park, Seung Chul Jung, Danbi Park & Dae Chul Suh

  2. Department of Neurosurgery, Ilsan Paik Hospital, College of Medicine, Inje University, Goyang, Korea

    Hae-Won Koo

  3. Department of Interventional Radiology, Taizhou People’s Hospital, 225300, Taizhou, Jiangsu Province, P. R. China

    Hairi Liu

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  1. Ji Eun Park
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  2. Hae-Won Koo
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  3. Hairi Liu
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  4. Seung Chul Jung
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  6. Dae Chul Suh
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Correspondence to Dae Chul Suh.

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Conflict of Interests

Ji E.P., Hae-Won K., Hairi L., Seung C.J., Danbi P., Dae C.S. state that they have no conflict of interests.

Ethical standards

All investigations described in this article were carried out in accordance with national law and the Helsinki Declaration of 1975 (in its current revised form). Ethics approval was obtained from the local ethical review committee of Asan Medical Center. All included patients provided written informed consent.

Additional information

Ji Eun Park and Hae-Won Koo contributed equally to the manuscript.

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Park, J.E., Koo, HW., Liu, H. et al. Clinical Characteristics and Treatment Outcomes of Spinal Arteriovenous Malformations. Clin Neuroradiol 28, 39–46 (2018). https://doi.org/10.1007/s00062-016-0541-0

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  • DOI: https://doi.org/10.1007/s00062-016-0541-0

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