Tags

Type your tag names separated by a space and hit enter

Direct surgery for spinal arteriovenous fistulas of the filum terminale with intraoperative image guidance.
Spine (Phila Pa 1976). 2012 Nov 15; 37(24):E1524-8.S

Abstract

STUDY DESIGN

A technical case report of direct surgery for spinal arteriovenous fistulas of the filum terminale.

OBJECTIVE

We present 2 cases of spinal arteriovenous fistulas of the filum terminale directly fed by the anterior spinal artery that were successfully obliterated with intraoperative image guidance such as digital subtraction angiography, intra-arterial dye injection technique, or indocyanine green video angiography.

SUMMARY OF BACKGROUND DATA

The goal of direct surgery for spinal arteriovenous fistulas is the complete obliteration of shunt vessels while preserving the normal circulation of spinal cord. Safe isolation of feeding arteries, nidus, and draining veins needs to be obtained first. Vascular flow or anatomical orientation of shunt vessels also needs to be ensured with intraoperative image guidance.

METHODS

Two cases are presented. The first patient (case 1) had the lesion with a nidus formation at the L2 spinal level supplied directly by the anterior spinal artery via left L1 segmental artery. The second patient (case 2) had a lesion at the L4-L5 spinal level also supplied directly by the anterior spinal artery via the left T11 intercostal artery. Standard exposure of the lesion followed intraoperative image guidance to achieve the appropriate vascular flow or anatomical orientation of the shunt vessels.

RESULTS

Complete obliteration of shunt vessels was successfully achieved without any complications in both cases.

CONCLUSION

Although intraoperative image guidance is certainly not a prerequisite, the concept of safe and minimally invasive surgery makes it indispensable. It can facilitate identification of crucial or important landmarks where anatomic structures may be distorted.

Authors+Show Affiliations

Department of Neurosurgery, Osaka City University Graduate School of Medicine, Osaka, Japan. ttakami@med.osaka-cu.ac.jpNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22914702

Citation

Takami, Toshihiro, et al. "Direct Surgery for Spinal Arteriovenous Fistulas of the Filum Terminale With Intraoperative Image Guidance." Spine, vol. 37, no. 24, 2012, pp. E1524-8.
Takami T, Yamagata T, Mitsuhashi Y, et al. Direct surgery for spinal arteriovenous fistulas of the filum terminale with intraoperative image guidance. Spine (Phila Pa 1976). 2012;37(24):E1524-8.
Takami, T., Yamagata, T., Mitsuhashi, Y., Hayasaki, K., & Ohata, K. (2012). Direct surgery for spinal arteriovenous fistulas of the filum terminale with intraoperative image guidance. Spine, 37(24), E1524-8. https://doi.org/10.1097/BRS.0b013e31826f20c0
Takami T, et al. Direct Surgery for Spinal Arteriovenous Fistulas of the Filum Terminale With Intraoperative Image Guidance. Spine (Phila Pa 1976). 2012 Nov 15;37(24):E1524-8. PubMed PMID: 22914702.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Direct surgery for spinal arteriovenous fistulas of the filum terminale with intraoperative image guidance. AU - Takami,Toshihiro, AU - Yamagata,Toru, AU - Mitsuhashi,Yutaka, AU - Hayasaki,Koji, AU - Ohata,Kenji, PY - 2012/8/24/entrez PY - 2012/8/24/pubmed PY - 2013/5/1/medline SP - E1524 EP - 8 JF - Spine JO - Spine (Phila Pa 1976) VL - 37 IS - 24 N2 - STUDY DESIGN: A technical case report of direct surgery for spinal arteriovenous fistulas of the filum terminale. OBJECTIVE: We present 2 cases of spinal arteriovenous fistulas of the filum terminale directly fed by the anterior spinal artery that were successfully obliterated with intraoperative image guidance such as digital subtraction angiography, intra-arterial dye injection technique, or indocyanine green video angiography. SUMMARY OF BACKGROUND DATA: The goal of direct surgery for spinal arteriovenous fistulas is the complete obliteration of shunt vessels while preserving the normal circulation of spinal cord. Safe isolation of feeding arteries, nidus, and draining veins needs to be obtained first. Vascular flow or anatomical orientation of shunt vessels also needs to be ensured with intraoperative image guidance. METHODS: Two cases are presented. The first patient (case 1) had the lesion with a nidus formation at the L2 spinal level supplied directly by the anterior spinal artery via left L1 segmental artery. The second patient (case 2) had a lesion at the L4-L5 spinal level also supplied directly by the anterior spinal artery via the left T11 intercostal artery. Standard exposure of the lesion followed intraoperative image guidance to achieve the appropriate vascular flow or anatomical orientation of the shunt vessels. RESULTS: Complete obliteration of shunt vessels was successfully achieved without any complications in both cases. CONCLUSION: Although intraoperative image guidance is certainly not a prerequisite, the concept of safe and minimally invasive surgery makes it indispensable. It can facilitate identification of crucial or important landmarks where anatomic structures may be distorted. SN - 1528-1159 UR - https://www.unboundmedicine.com/medline/citation/22914702/Direct_surgery_for_spinal_arteriovenous_fistulas_of_the_filum_terminale_with_intraoperative_image_guidance_ L2 - https://doi.org/10.1097/BRS.0b013e31826f20c0 DB - PRIME DP - Unbound Medicine ER -