• Mehmet Yigit Akgun, Rahsan Kemerdere, Mustafa Onur Ulu, Orkhan Alizada, Cihan Isler, Osman Kizilkilic, Civan Islak, and Murat Hanci.
• Department of Neurosurgery, Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, Istanbul, Turkey. Electronic address: myigitakgun@gmail.com.
• World Neurosurg. 2019 Oct 1; 130: e953-e960.

BackgroundVascular malformations of the spinal cord are a rare and complex clinical entity and can lead to severe morbidity with progressive spinal cord symptoms if not treated properly. In early stages, the disease is characterized by slowly progressive, nonspecific symptoms, such as gait disturbance, paresthesia, diffuse sensory symptoms, and radicular pain; in the late stages, bowel and bladder incontinence, erectile dysfunction, and urinary retention may develop. In recent decades, understanding and treatment of spinal vascular malformations have improved with the evolution of diagnostic tools and treatment modalities; however, it is still difficult to manage these cases because of the complexity of the pathology. The aims of this study were to present the long-term outcomes of our patients and to discuss the optimal management strategies.MethodsWe reviewed the records of 78 patients with spinal vascular malformations and performed a retrospective, single-center case series evaluating initial occlusion, recanalization, retreatment, and neurologic status of patients with dural arteriovenous fistulas, perimedullary arteriovenous fistulas, arteriovenous malformations, and extradural arteriovenous fistulas who had undergone embolization and/or surgery.ResultsNo mortality was observed. Complete obliteration was achieved in 76 patients (97.4%).ConclusionsBoth endovascular and surgical treatment of spinal vascular malformations resulted in significant long-term recovery from myelopathic symptoms and improvement in quality of life for most patients.Copyright © 2019 Elsevier Inc. All rights reserved.

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