Complications of Surgery for Spinal Vascular Malformations

Abstract Spinal vascular malformations (AVMs), particularly intradural intramedullary AVMs (i.e., type II or glomus AVMs), are complex lesions that are often difficult to manage. Their complexity relates to the possibility of injury to the spinal cord and its blood supply, resulting in devastating neurologic injury. A thorough familiarity with normal and pathologic anatomy is important, as is an understanding that leaving residual AVM after embolization and resection is better than causing neurologic injury. For intramedullary AVMs, which are located partially or completely in the spinal cord parenchyma and sometimes bridge the pial surface, we use a pial resection technique that produces excellent results.