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New grading system for the clinical evaluation of patients with spinal vascular lesions

  • Spinal Neuroradiology
  • Published:
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Abstract

Purpose

Neurointerventional approaches have improved myelopathy in patients with spinal vascular lesions by providing effective management, particularly when surgical approaches are difficult. However, there have been challenges in describing and comparing recovery status during the post-treatment period.

Methods

We evaluated 43 patients with venous congestive myelopathy (VCM) using Aminoff–Logue Disability Scale for gait (AL-G) and micturition (AL-M) scores. These results were compared with our new PSMS grading system that evaluates four categories (grades 0–3): pain, sensory symptoms, motor deficit, and sphincter change. Simple linear regression was used to identify the association or trend among the scales. We also calculated an overall area under the receiver operating characteristic curve to compare the predictive ability of the PSMS system with that of the previous grading system (AL-G and AL-M).

Results

Compared with other grading system, the PSMS system was more sensitively correlated with patient status and the results were easy to compare with previous clinical statuses during follow-up. The PSMS system also measured pain, which is commonly associated with spinal dural arteriovenous fistula and not precisely evaluated by other grading system.

Conclusions

The new PSMS grading system for patients with VCM correlated well with the previously used systems and included pain evaluation. This new grading system is an easy tool for the evaluation and comparison of outcomes before and after endovascular treatment.

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References

  1. Aminoff MJ, Barnard RO, Valentine L (1974) The pathophysiology of spinal vascular malformation. J Neurol Sci 23:255–263

    Article  CAS  PubMed  Google Scholar 

  2. Aminoff MJ, Logue V (1974) The prognosis of patients with spinal vascular malformations. Brain 97:211–218

    Article  CAS  PubMed  Google Scholar 

  3. Aminoff MJ, Logue V (1974) Clinical features of spinal vascular malformations. Brain 97:197–210

    Article  CAS  PubMed  Google Scholar 

  4. Krings T, Lasjaunias PL, Hans FJ, Mull M, Nijenhuis RJ, Alvarez H, Backes WH, Reinges MHT, Rodesch G, Gilsbach JM, Thron AK (2007) Imaging in spinal vascular disease. Neuroimaging Clin N Am 17:57–72. https://doi.org/10.1016/j.nic.2007.01.001

    Article  PubMed  Google Scholar 

  5. Jung SC, Song Y, Cho SH, Kim J, Noh SY, Lee SH, Sheen JJ, Rhim SC, Jeon SR, Suh DC (2018) Endovascular management of aneurysms associated with spinal arteriovenous malformations. J Neurointerv Surg 10:198–203. https://doi.org/10.1136/neurintsurg-2017-013150

    Article  PubMed  Google Scholar 

  6. Chaudhary N, Pandey AS, Gemmete JJ (2013) Endovascular treatment of adult spinal arteriovenous lesions. Neuroimaging Clin N Am 23:729–747. https://doi.org/10.1016/j.nic.2013.03.017

    Article  PubMed  Google Scholar 

  7. Krings T, Thron AK, Geibprasert S, Agid R, Hans FJ, Lasjaunias PL, Reinges MHT (2010) Endovascular management of spinal vascular malformations. Neurosurg Rev 33:1–9. https://doi.org/10.1007/s10143-009-0204-6

    Article  PubMed  Google Scholar 

  8. Rodesch G, Hurth M, Alvarez H, Tadie M, Lasjaunias P (2002) Classification of spinal cord arteriovenous shunts: proposal for a reappraisal--the Bicetre experience with 155 consecutive patients treated between 1981 and 1999. Neurosurgery 51:374–379 discussion 379-380

    PubMed  Google Scholar 

  9. Rodesch G, Lasjaunias P (2003) Spinal cord arteriovenous shunts: from imaging to management. Eur J Radiol 46:221–232

    Article  CAS  PubMed  Google Scholar 

  10. Shi HB, Suh DC, Lee HK et al (1999) Preoperative transarterial embolization of spinal tumor: embolization techniques and results. AJNR Am J Neuroradiol 20:2009–2015

    CAS  PubMed  Google Scholar 

  11. Krings T, Geibprasert S (2009) Spinal dural arteriovenous fistulas. AJNR Am J Neuroradiol 30:639–648. https://doi.org/10.3174/ajnr.A1485

    Article  CAS  PubMed  Google Scholar 

  12. Lee C-S, Pyun HW, Chae EY, Kim K-K, Rhim SC, Suh DC (2009) Reversible aggravation of neurological deficits after steroid medication in patients with venous congestive myelopathy caused by spinal arteriovenous malformation. Interv Neuroradiol 15:325–329

    Article  PubMed  PubMed Central  Google Scholar 

  13. Park JE, Koo HW, Liu H, Jung SC, Park D, Suh DC (2018) Clinical characteristics and treatment outcomes of spinal arteriovenous malformations. Clin Neuroradiol 28:39–46. https://doi.org/10.1007/s00062-016-0541-0

    Article  PubMed  Google Scholar 

  14. Chul Suh D, Gon Choi C, Bo Sung K, Kim KK, Chul Rhim S (2004) Spinal osseous epidural arteriovenous fistula with multiple small arterial feeders converging to a round fistular nidus as a target of venous approach. AJNR Am J Neuroradiol 25:69–73

    PubMed  Google Scholar 

  15. Adrianto Y, Yang KH, Koo HW, Park W, Jung SC, Park JE, Kim KK, Jeon SR, Suh DC (2017) Concomitant origin of the anterior or posterior spinal artery with the feeder of a spinal dural arteriovenous fistula (SDAVF). J Neurointerv Surg 9:405–410. https://doi.org/10.1136/neurintsurg-2016-012267

    Article  PubMed  Google Scholar 

  16. Suh DC, Kim HS, Baek HJ, Park JW, Kim KK, Rhim SC (2012) Angioarchitecture of spinal dural arteriovenous fistula - evaluation with 3D rotational angiography. Neurointervention 7:10–16. https://doi.org/10.5469/neuroint.2012.7.1.10

    Article  PubMed  PubMed Central  Google Scholar 

  17. Suh DC, Cho SH, Park JE, Liu H, Jung SC (2016) Induced-wedge technique to improve liquid embolic agent penetration into spinal dural arteriovenous fistula. World Neurosurg 96:309–315. https://doi.org/10.1016/j.wneu.2016.09.002

    Article  PubMed  Google Scholar 

  18. Breivik H, Borchgrevink PC, Allen SM, Rosseland LA, Romundstad L, Breivik Hals EK, Kvarstein G, Stubhaug A (2008) Assessment of pain. Br J Anaesth 101:17–24. https://doi.org/10.1093/bja/aen103

    Article  CAS  PubMed  Google Scholar 

  19. Cameron AP, Rodriguez GM, Gursky A, He C, Clemens JQ, Stoffel JT (2015) The severity of bowel dysfunction in patients with neurogenic bladder. J Urol 194:1336–1341. https://doi.org/10.1016/j.juro.2015.04.100

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro, 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea

    Dae Chul Suh, Yunsun Song, Danbi Park, Ji Eun Park & Sang Hun Lee

  2. Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea

    Minkyu Han

  3. Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea

    Young-Min Lim & Kwang-Kuk Kim

  4. Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea

    Sang Ryong Jeon

Authors
  1. Dae Chul Suh
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  2. Yunsun Song
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  3. Danbi Park
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  4. Minkyu Han
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  5. Young-Min Lim
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  6. Ji Eun Park
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  7. Sang Hun Lee
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  8. Sang Ryong Jeon
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  9. Kwang-Kuk Kim
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Corresponding author

Correspondence to Dae Chul Suh.

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Funding

This work was funded by the National Research Foundation of Korea (NRF) grant funded by the Korean government (MSIT) (No. 2018R1A2B6003143).

Conflict of interest

The authors declare that they have no conflict of interest.

Ethics approval

All procedures performed in the studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.

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For this type of retrospective study formal consent is not required.

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Suh, D.C., Song, Y., Park, D. et al. New grading system for the clinical evaluation of patients with spinal vascular lesions. Neuroradiology 60, 1035–1041 (2018). https://doi.org/10.1007/s00234-018-2076-3

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  • DOI: https://doi.org/10.1007/s00234-018-2076-3

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