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首页> 外文期刊>British journal of neurosurgery >Spinal dural arteriovenous fistulas-presentation, management and outcome in a single neurosurgical institution
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Spinal dural arteriovenous fistulas-presentation, management and outcome in a single neurosurgical institution

机译：脊柱硬化动脉动脉瘘 - 单一神经外科机构的介绍，管理和结果

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Objective. To compare the outcome, with respect to treatment modality, of patients treated with spinal dural arteriovenous fistulas (SDAVF). Method. Retrospective cohort study of patients with SDAVF assessed at a single tertiary referral centre, between 1999 and 2009. Intervention type, pre-/ post-intervention Aminoff-Logue disability score (ALDS) and recurrence rate were obtained from medical records. Results. 26 patients were identified with 23 receiving intervention. All patients initially received super selective angiogram, with 13 undergoing endovascular embolization at this stage, after discussion between the surgeon and interventional radiologist. Six patients who underwent embolization had a recurrence. The remaining 10 patients had fistulas marked during angiography, and were then treated surgically, after discussion. One of these recurred. The difference in recurrence rate between the two intervention types was not statistically significant. Fistulas treated with the embolization material onyx were twice as likely to recur as those treated with the alternative material, histoacryl-lipiodol. There was a statistically significant difference between the modes of intervention in relation to clinical outcome. Surgeries lead to an improvement in neurology, whereas treatment via embolization did not. Neurological improvement was seen in non-recurring cases, however deterioration in neurological function occurred with fistula recurrence. Conclusion. Super selective angiography is effective in defining the relevant vascular anatomy and allows for precise fistula localization during any potential subsequent surgery. Onyx was associated with a higher recurrence rate, suggesting it is less suitable as an embolization material for SDAVF treatment. Surgery appeared to correlate to reversal of neurological impairment seen at presentation, possibly due to a lower recurrence rate. The study is limited by small patient numbers, emphasizing the need for further studies of SDAVF patients.
机译：客观的。为了将结果与脊椎多久动脉瘘（SDAVF）进行治疗患者的治疗方式。方法。在1999年至2009年间，在单一第三届推荐中心评估的SDAVF患者的回顾性队列研究。从医疗记录中获得干预型，/介入后的氨基烃算法残疾人评分（ALDS）和复发率。结果。 26例患者用23例接受干预鉴定。所有患者初步接受超级选择性血管造影，在外科医生和介入放射科医师之间讨论后，在此阶段接受血管内栓塞。患有栓塞的六名患者复发。其余10名患者在血管造影期间具有标记的瘘管，然后在讨论后手术治疗。其中一个重复。两种干预类型之间的复发率的差异在统计学上没有统计学意义。用栓塞材料onyx处理的瘘管是用替代材料，组织酰丙烯碘醇处理的那些次数的两倍。关于临床结果的干预模式之间存在统计学上的差异。手术导致神经内科的改善，而通过栓塞治疗没有。在非经常性案例中看到神经系统改善，但是瘘管复发发生神经功能的恶化。结论。超级选择性血管造影在定义相关的血管解剖学方面是有效的，并允许在任何潜在的后续手术中进行精确的瘘管定位。 Onyx与较高的复发率相关，表明它不太适合作为SDAVF治疗的栓塞材料。手术似乎与呈现的神经损伤逆转相关，可能是由于较低的复发率。该研究受小患者数量的限制，强调需要进一步研究SDAVF患者。

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