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Excision of high and mid cervical spinal cord arteriovenous malformations by anterior operation.
J Clin Neurosci. 2005 Jan; 12(1):71-9.JC

Abstract

Symptomatic cervical spinal arteriovenous malformations (AVMs) located on the anterior aspect of the spinal cord are rare and surgical removal of these AVMs presents considerable challenges and risks. Surgical techniques to date have usually been by posterior approach and lateral dissection around the cord or via midline myelotomy, both approaches involving cord manipulation and retraction and in the latter, dissection through the spinal cord. We present two teenage patients with symptomatic anteriorly placed mid to high cervical spinal AVMs and associated aneurysm in which excision of the AVMs and aneurysm was performed by an anterior approach using vertebrectomy/corpectomy. The first case had a small perimedullary glomus-type AVM with an aneurysm on the anterior aspect of the cord at the C3/4 level; excision was performed using a single level vertebrectomy/corpectomy, the patient remaining neurologically intact. The second case had a medium-sized juvenile AVM with an aneurysm, both perimedullary and intramedullary, centred at the C5/6 level; excision was performed using a two-level vertebrectomy/corpectomy with no deterioration in the marked pre-operative tetraparesis, which at long-term follow up had improved and stabilised. Anterior approaches have been recently described for treatment of anteriorly placed cervical arteriovenous fistulas (AVFs) and an intramedullary haemangioblastoma, but not as yet for spinal AVMs. These are the first two reported cases of anteriorly situated cervical AVMs successfully removed surgically by an anterior approach and with good neurological outcomes.

Authors+Show Affiliations

MacFarlane MR
Department of Neurosurgery, Christchurch Hospital, New Zealand. martin.macfarlane@cdhb.govt.nz
Burn PJ
No affiliation info available
Evison J
No affiliation info available

MeSH

AdolescentArteriovenous FistulaArteriovenous MalformationsChildFemaleHumansMagnetic Resonance AngiographyMagnetic Resonance ImagingMaleMicrosurgeryQuadriplegiaRadiographySpinal Cord Vascular DiseasesSubarachnoid HemorrhageTreatment OutcomeVascular Surgical Procedures

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

15639418

Citation

MacFarlane, Martin R., et al. "Excision of High and Mid Cervical Spinal Cord Arteriovenous Malformations By Anterior Operation." Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia, vol. 12, no. 1, 2005, pp. 71-9.
MacFarlane MR, Burn PJ, Evison J. Excision of high and mid cervical spinal cord arteriovenous malformations by anterior operation. J Clin Neurosci. 2005;12(1):71-9.
MacFarlane, M. R., Burn, P. J., & Evison, J. (2005). Excision of high and mid cervical spinal cord arteriovenous malformations by anterior operation. Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia, 12(1), 71-9.
MacFarlane MR, Burn PJ, Evison J. Excision of High and Mid Cervical Spinal Cord Arteriovenous Malformations By Anterior Operation. J Clin Neurosci. 2005;12(1):71-9. PubMed PMID: 15639418.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Excision of high and mid cervical spinal cord arteriovenous malformations by anterior operation. AU - MacFarlane,Martin R, AU - Burn,P James, AU - Evison,Jeremy, PY - 2004/05/20/received PY - 2004/07/02/accepted PY - 2005/1/11/pubmed PY - 2006/5/2/medline PY - 2005/1/11/entrez SP - 71 EP - 9 JF - Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia JO - J Clin Neurosci VL - 12 IS - 1 N2 - Symptomatic cervical spinal arteriovenous malformations (AVMs) located on the anterior aspect of the spinal cord are rare and surgical removal of these AVMs presents considerable challenges and risks. Surgical techniques to date have usually been by posterior approach and lateral dissection around the cord or via midline myelotomy, both approaches involving cord manipulation and retraction and in the latter, dissection through the spinal cord. We present two teenage patients with symptomatic anteriorly placed mid to high cervical spinal AVMs and associated aneurysm in which excision of the AVMs and aneurysm was performed by an anterior approach using vertebrectomy/corpectomy. The first case had a small perimedullary glomus-type AVM with an aneurysm on the anterior aspect of the cord at the C3/4 level; excision was performed using a single level vertebrectomy/corpectomy, the patient remaining neurologically intact. The second case had a medium-sized juvenile AVM with an aneurysm, both perimedullary and intramedullary, centred at the C5/6 level; excision was performed using a two-level vertebrectomy/corpectomy with no deterioration in the marked pre-operative tetraparesis, which at long-term follow up had improved and stabilised. Anterior approaches have been recently described for treatment of anteriorly placed cervical arteriovenous fistulas (AVFs) and an intramedullary haemangioblastoma, but not as yet for spinal AVMs. These are the first two reported cases of anteriorly situated cervical AVMs successfully removed surgically by an anterior approach and with good neurological outcomes. SN - 0967-5868 UR - https://www.unboundmedicine.com/medline/citation/15639418/Excision_of_high_and_mid_cervical_spinal_cord_arteriovenous_malformations_by_anterior_operation_ DB - PRIME DP - Unbound Medicine ER -