Ouyang Y, Qu Y, Dong RP, Kang MY, Yu T, Cheng XL, Zhao JW. Spinal dural arteriovenous fistula 8 years after lumbar discectomy surgery: A case report and review of literature. World J Clin Cases 2021; 9(20): 5594-5604 [PMID: 34307614 DOI: 10.12998/wjcc.v9.i20.5594]
Corresponding Author of This Article
Jian-Wu Zhao, PhD, Doctor, Department of Orthopaedics, The Second Hospital of Jilin University, No. 218 Ziqiang Street, Nanguan District, Changchun 130041, Jilin Province, China. jianwu@jlu.edu.cn
Research Domain of This Article
Orthopedics
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Jul 16, 2021; 9(20): 5594-5604 Published online Jul 16, 2021. doi: 10.12998/wjcc.v9.i20.5594
Spinal dural arteriovenous fistula 8 years after lumbar discectomy surgery: A case report and review of literature
Yang Ouyang, Yang Qu, Rong-Peng Dong, Ming-Yang Kang, Tong Yu, Xue-Liang Cheng, Jian-Wu Zhao
Yang Ouyang, Yang Qu, Rong-Peng Dong, Ming-Yang Kang, Tong Yu, Xue-Liang Cheng, Jian-Wu Zhao, Department of Orthopaedics, The Second Hospital of Jilin University, Changchun 130041, Jilin Province, China
Author contributions: Ouyang Y, Qu Y, Dong RP and Kang MY were the patient’s neurosurgeons, and they also reviewed the literature and contributed to manuscript drafting; Yu T and Cheng XL reviewed and analyzed imaging findings; Zhao JW reviewed the whole manuscript and revised it; all authors issued final approval for the version to be submitted.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jian-Wu Zhao, PhD, Doctor, Department of Orthopaedics, The Second Hospital of Jilin University, No. 218 Ziqiang Street, Nanguan District, Changchun 130041, Jilin Province, China. jianwu@jlu.edu.cn
Received: March 1, 2021 Peer-review started: March 1, 2021 First decision: May 11, 2021 Revised: May 19, 2021 Accepted: May 27, 2021 Article in press: May 27, 2021 Published online: July 16, 2021 Processing time: 127 Days and 23.9 Hours
Abstract
BACKGROUND
Spinal dural arteriovenous fistula (SDAVF) is an extremely rare vascular malformation of the central nervous system that is often confused with degenerative spinal disorders due to similar early symptoms and clinical features. Here, we report a case of SDAVF recurrence 8 years after lumbar spine surgery and summarize relevant literature.
CASE SUMMARY
A 54-year-old male was admitted to our hospital complaining of lower back pain, numbness in both lower extremities and intermittent claudication. Subsequent imaging identified lumbar spinal stenosis. Following surgical treatment, the patient’s symptoms significantly resolved, and he was able to perform daily activities. However, similar symptoms appeared 8 years later, followed by confirmation of SDAVF diagnosis. The patient underwent neurosurgery 7 mo after symptom onset. The follow-up period lasted 14 mo, and the patient remains with marginal neurological symptoms.
CONCLUSION
This case highlights the importance of prompt SDAVF diagnosis. Due to its nonspecific clinical presentation, the clinical experience of the surgeon and definitive imaging examination are indispensable. Additionally, timely neurosurgery is effective and may significantly improve patient outcomes.
Core Tip: Spinal dural arteriovenous fistulas (SDAVFs) are rare disorders because its onset and early symptoms resemble more common disorders, especially spinal degeneration disease. It is therefore often misdiagnosed and misclassified, resulting in ineffective clinical interventions, hence poor prognosis. Here, we report a case of SDAVF that went into remission, but symptoms recurred 8 years later as lumbar spinal stenosis, supporting the idea that SDAVF is an acquired disorder. Currently, imaging is an important way of confirming SDAVF diagnosis. Early, effective treatment may significantly improve SDAVF prognosis.
