经单侧椎板开窗夹闭硬脊膜动静脉瘘

Interruption of Spinal Dural Arteriovenous Fistulas by Hemilaminectomy Approach

目的 总结经单侧椎板开窗入路夹闭硬脊膜动静脉瘘的经验。方法 回顾性分析了 5 6例经脊髓MR和脊髓血管造影确诊的硬脊膜动静脉瘘患者经单侧椎板开窗夹闭瘘口的临床资料。结果 5 4例患者术后行脊髓血管造影复查 ,显示瘘口全部消失。 38例患者术后 6个月行脊髓MR复查 ,显示脊髓周围的血管流空影完全消失 ,T2 像髓内高信号影消失或明显减少。 5 4例患者获随访 ,随访时间 3～ 36个月 ,2 4例症状完全消失 ,2 7例症状改善 ,3例无变化。结论 经单侧椎板开窗夹闭瘘口的手术方法是硬脊膜动静脉瘘的首选治疗方法。

Objective To discuss the clinincal experience of interruption of spinal dural arteriovenous fistulas (SDAVF) by hemilaminectomy approach. Methods the clinical data from 56 patients with SDAVF diagnosed by spinal MRI and spinal angiography, interrupted by hemilaminectomy approach were analyzed retrospectively. Results Complete disappearance of SDAVF was confirmed in 54 patients who received postoperative spinal angiography. Spinal MRI at 6 months after surgery in 38 cases showed paramedullary tortuous flow voids disappeared and intramedullary high signal disappeared or decreased obviously. Follow-up of 54 patients showed complete recovery in 26 patients, improvement in 27, and no change in 3. Conclusions Interruption of fistulas by hemilanimectomy approach was the first choice for SDAVF treatment.