• Bingying Du, Meng Liang, Cunxiu Fan, Xiaoyan Lu, Hailing Zhang, Qiang Li, Yi Xu, Jianmin Liu, and Xiaoying Bi.
• Department of Neurology, Shanghai Changhai Hospital, The Second Military Medical University, Shanghai, P.R. China; Department of Neurology, General Hospital of Central Theater Command of Chinese People's Liberation Army, Wuhan, Hubei, P.R. China.
• World Neurosurg. 2020 Jun 1; 138: e177-e182.

BackgroundSpinal dural arteriovenous fistula (SDAVF) is a rare spinal vascular malformation which can cause permanent neurologic dysfunction. The purpose of this study was to investigate the relationship between the clinical and imaging characteristics of SDAF and its prognosis.MethodsAll patients diagnosed with SDAVF and hospitalized in our hospital from February 2004 to September 2018 were retrospectively recruited. The clinical and imaging data of these patients were collected, and then a subgroup analysis was performed to find the association between clinical and imaging characteristics of SDAF and its prognosis.ResultsA total of 79 patients were included in the analysis. The median age of the patients was 59 years, with men having a predominant morbidity (84.4%). The mean duration of symptoms was 7 months, and most patients had more than 2 symptoms before hospitalization (n = 43, 44.4%). The fistula mainly occurred in the lower thoracic spine (n = 40, 50.6%), followed by the lumbar spine (n = 18, 22.8%) and upper thoracic spine (n = 16, 20.3%). Of 58 patients with magnetic resonance images available, 45 (77.6%) were identified with high T2-weighted image (T2WI) signal in the spinal cord, and 51 (87.9%) with T2WI flow voids on the spinal surface. Multivariate logistic regression analysis found that preoperative Aminoff-Logue Scale (ALS) scores were associated with postoperative function improvement after adjustment for sex, age, and duration of symptoms (P = 0.013; odds ratio, 1.375; 95% confidence interval, 1.07-1.77).ConclusionsPreoperative ALS scores are associated with improved prognosis in patients with SDAVF. Both surgical ligation and endovascular embolization can improve functional outcomes and delay disease progression.Copyright © 2020. Published by Elsevier Inc.

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