Spinal Dural Arteriovenous Fistulas

Spinal dural arteriovenous fistula (SDAVF) is a rare and often poorly diagnosed spinal pathology. They mainly occur in males in the fifth or sixth decade of life, with the most common involving the thoracolumbar region, although SDAVF can occur anywhere along the spinal cord. The clinical symptoms presented often have insidious and nonspecific onset, such as weakness of the lower limbs and pain. The symptoms may slowly develop into severe myelopathy with paraplegia within a few years. These symptoms and accompanying imaging findings are often attributed to more common and occasionally coexisting pathological processes, such as degenerative spinal stenosis or demyelinating/inflammatory myelitis. Early diagnosis of SDAVFs is important. Defects may be reversible, but delayed treatment may lead to irreversible neurological dysfunction. Imaging diagnosis mainly relies on magnetic resonance imaging (MRI) and traditional spinal angiography. Once SDAVF is detected, the treatment method is intravascular embolization or surgical obliteration of the fistula.