• Spinal Vascular Malformations

    What are spinal AVMs?

    A spinal AVM is located within the spinal canal. AVMs are an abnormal collection of blood vessels that have a direct connection between the arterial system and the venous system without intervening capillaries. This arrangement increases the risk of bleeding from these vessels.

    What are the different types of spinal AVMs?

    The main types of spinal AVMs include:

    • Spinal dural AVMS, or fistula: This is the most common type of AVM. In this case there is an abnormal communication between artery and vein associated with a nerve root.
    • Glomus and Juvenile: These are subtypes found within the spinal cord.
    • Perimedullary fistula: This is caused by an abnormal communication of artery and vein found on the surface of the spinal cord.

    What are the symptoms of spinal AVMs?

    Most spinal AVMs (85 percent) present with progressive neurological symptoms over months to years. These symptoms are usually back pain associated with progressive sensory loss and lower extremity weakness. A smaller percentage (10 to 20 percent) of spinal cord AVMs present as a sudden onset of weakness, numbness, difficulty urinating, urinary incontinence, fecal incontinence, or paralysis (usually in patients younger than 30 years of age) due to acute hemorrhage.

    How are spinal AVMs diagnosed?

    Spinal Angiogram revealing dilated loops of veins typical of a spinal dural AVMMRI scanning has increased the likelihood of identifying these lesions. The increased anatomical detail seen by MRI usually reveals the presence of these lesions. Once these lesions are identified, the vascular structure of these lesions can usually be delineated by spinal angiography.
     

    How are spinal AVMs treated? 

    Depending on the type, treatment may consist of endovascular surgery, microsurgery, or combinations of both. Using endovascular techniques, a catheter is threaded into the vessel feeding the fistula. Microsurgery uses special microdissection techniques and high magnification to identify and disconnect the abnormal communication or remove the AVM.

    At Lahey Hospital & Medical Center, we have extensive experience in treating these disorders. A multidisciplinary neurovascular team formulates a treatment plan. The designated team will take into careful consideration the patient's clinical history, symptoms, physical examination, and the diagnostic studies available.
     

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