Current Status of the Treatment for Spinal Dural Arteriovenous Fistulas

Spinal dural arteriovenous fistula (SDAVF) is a rare disease. Currently, the understanding of SDAVFs is not complete. Therefore, we performed a review of this condition. The following characteristics of SDAVF were discussed: natural history and current diagnosed state, anatomy and angioarchitecture, therapeutic goals and options, therapeutic techniques, complications and recurrence, and prognosis. We found that SDAVF is a rare disabling disease and is often misdiagnosed. SDAVF has a poor natural history, and spontaneous disappearance is uncommon. SDAVF has a complex angioarchitecture, which is the consequence of the arteriovenous shunt and venous medullary outflow impairment or obstruction. SDAVF is a potentially curable cause and thus should be treated aggressively. Surgical and endovascular interventions can be used. Microsurgery appeared to be an efficient method in terms of the clinical effect, radicality, and lower recurrence in comparison with endovascular embolization. However, endovascular embolization is becoming popular due to advances in the techniques. Although there are complications and unsatisfactory prognoses, SDAVF treatments are still recommended; moreover, the sooner the treatment is administered, the better the prognosis.