Spinal dural arteriovenous fistula formation after scoliosis surgery: case report

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Spinal dural arteriovenous fistulas are diagnostically challenging lesions, and they are not well described in patients with a history of a spinal deformity correction. The authors present the challenging case of a 74-year-old woman who had previously undergone correction of a spinal deformity with subsequent revision. Several years after the last deformity operation, she developed a progressive myelopathy with urinary incontinence over a 6-month period. After evaluation at the authors’ institution, an angiogram was obtained, demonstrating a fistula at the T12–L1 region. Surgical ligation of the fistula was performed with subsequent improvement of the neurological symptoms. This case is thought to represent the first fistula documented in an area of the spine that had previously been operated on, and to the authors’ knowledge, it is the first case report to be associated with spinal deformity surgery. A brief historical overview and review of the pathophysiology of spinal dural arteriovenous fistulas is also included.

ABBREVIATIONS AVF = arteriovenous fistula; AVM = arteriovenous malformation; dAVF = dural AVF; ICG = indocyanine green.
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Contributor Notes

Correspondence Mark E. Oppenlander: University of Michigan, Ann Arbor, MI. moppenla@med.umich.edu.INCLUDE WHEN CITING Published online September 20, 2019; DOI: 10.3171/2019.6.SPINE19323.Disclosures Dr. Oppenlander: consultant for Globus Medical, DePuy Spine, and LifeNet Health.
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