Spinal AV Fistula Disconnection

Microsurgical Management of L1 Arteriovenous Fistula

Overall, spinal vascular malformations (SVMs) are relatively rare lesions that make up an estimated 10% of all central nervous system vascular malformations. These vascular lesions are classified according to their vascular angioarchitecture and nidal location. Spinal dural arteriovenous fistulas (sDAFs) represent the most common type of SVM (50-85%).

Spinal dural arteriovenous fistulas are a heterogeneous group of predominantly acquired pathologic vascular malformations that are defined by an abnormal connection between an artery and a vein.

The pathogenesis of sDAVFs is yet to be fully elucidated, conversely to their intracranial counterparts, in which dural venous thrombosis and neoangiogenesis contribute to the abnormal recanalization of the primitive direct connections between the arteries and veins around the major dural venous sinuses. For a detailed discussion about intracranial DAVFs, please refer to the Principles of Dural Arteriovenous Fistulas chapter.

Classification of Spinal Vascular Malformations
Type Description
I Spinal dural arteriovenous fistulas (sDAVFs)(previously called angioma racemosum venosum): located at the dural sleeve of a spinal root, associated with a single-coiled vessel on the dorsal pial surface of the spinal cord
II Glomus AVMs (previously called angioma racemosum arteriovenosum): characterized by a true intramedullary nidus and arteriovenous shun...