Observation on the efficacy of hybrid surgery in the treatment of spinal dural arteriovenous fistula
Objective To investigate the clinical efficacy of hybrid operating techniques in the treatment for spinal dural arteriovenous fistulas(SDAVF).Methods A retrospective analysis was conducted on the clinical data of 18 consecutive SDAVF patients treated with hybrid operation in the Neurosurgery Department of Shanxi Provincial People's Hospital from May 2020 to March 2023.All patients underwent spinal cord angiography during operation to confirm the source of the supply artery,the location of the fistula and the extent of drainage venous.The fistulas at the beginning of drainage venous site were resected under microscope by bipolar electrocoagulation.After 6 months post surgery,imaging examinations were performed,and the efficacy was evaluated using the Modified Aminoff-Logue Scale(mALS)score.A score of 0 in mALS was considered as cured,a decrease of≥3 points from the preoperative score was considered as improved,and a decrease of＜3 points was considered as uncured.Results All patients successfully underwent the surgery,and intraoperative angiography confirmed the complete disappearance of the fistula and abnormal drainage veins.None of the patients experienced any complications related to the surgery or spinal cord angiography.After 6 months,Spinal MRI examination confirmed the absence of residual or recurrent lesions in all patients;the mALS score was 2.06±1.98,which showed significant improvement compared with the preoperative score of 5.56±2.62(P＜0.01).Out of all cases,6 were cured,11 showed improvement,and 1 was unhealed.Among the 7 cases with a disease course of less than 3 months,5 cases were cured and 2 cases showed improvement;among the 6 cases with a disease course of 3 to 12 months,1 case was cured and 5 cases showed improvement;among the 5 cases with a disease course of more than 12 months,4 cases showed improvement and 1 case was not cured.Conclusions Hybrid operating techniques for SDAVF can enhance the cure rate of lesions and decrease complications.Further research is needed to explore the connection between the prognosis and disease course.
NETL
NSTL
万方数据
