[Diagnosis and treatment of spinal dural arteriovenous fistulas: 110 cases report].

Objective To discuss the diagnosis, treatment and prognosis of spinal dural arteriovenous fistulas(SDAVF). Methods The clinical and following up date from 110 patients with SDAVF diagnosed by spinal MRI and spinal angiography were analyzed retrospectively. Results Draining vein between fistula and spinal cord was interrupted by laminectomy approach as first choice in 61 patients, by hemilaminectomy approach in 37, and by endovascular embolization in 12, and re operation due to recurrence after embolization in 3. Anticoagulation, hydration and early rehabilitation were used postoperatively. Complete disappearance of SDAVF was confirmed in all 106 patients who received postoperative spinal angiography. The paramedullary tortuous flow voids fully disappeared in 74 patients and partly disappeared in 15 on postoperative T 2 weighted MRI. Follow up of 98 patients showed complete recovery in 54 patients, improvement in 34, and no change in 10. Three of the 10 patients were reoperated on because of recurrence 1 to 5 years after embolization. Conclusions SDAVF can produce good outcome after early diagnosis and treatment. Interruption of the draining vein between fistula and spinal cord by hemilaminalectomy approach is the first choice for the treatment of SDAVF.