Spinal dural arteriovenous fistula 8 years after lumbar discectomy surgery: A case report and review of literature

Table 1 Aminoff and Logue scale score of disability

Modified Aminoff-Logue scale
Gait disturbance	Micturition
0 Normal	0 Normal
1 Leg weakness or abnormal gait; no restricted activity	1 Hesitance, urgency or frequency
2 Grade 1 with restricted activity	2 Occasional urinary incontinence or retention
3 Requires cane or similar support for walking	3 Total urinary incontinence or retention
4 Requires walker or crutches for walking
5 Unable to stand; confined to bed or wheelchair

Table 2 Clinical features of spinal dural arteriovenous fistula case reports published in recent years

Ref.	Age	MRI feature	Symptom	Duration of symptoms	Outcome
Derollez et al[27], 2019	76	Hypersignal of the spinal cord from T6 to the terminal cone and flow voids behind the spinal cord	Protopathic hypoesthesia, tactile allodynia, numbness in the soles of his feet and hypopallesthesia in the inferior limbs, especially on the right side	1 mo	Complete recovery of his motor and sphincterial dysfunctions, the only remaining symptom was paresthesia of his inferior limbs
Ren et al[28], 2019	61	T5 to the conus with multiple flow voids posterior to the spinal cord	Motor weakness (grade 4/5) and reduced sensation in both legs	6 mo	The patient’s symptoms gradually improved
Petrin et al[29], 2020	87	Diffuse spinal cord signal change from approximately the T3 to the conus medullaris with vascular patterns at the posterior aspect of the spinal canal	Intermittent loss of sensation in the legs, buckling of his legs with falls and multiple episodes of unexplained new-onset fecal incontinence	3 mo	The patient made significant functional recovery and return to independent activities of daily living
Li et al[30], 2017	65	Dilated tortuous vessels with flow voids extending from C4 to the cauda equina	Decreased muscle strength in both legs (grade 4), hypesthesia occurred below L3 level, defecation difficulty, urinary incontinence and erectile dysfunction	4 yr	The paresthesia and weakness in both legs and the sphincter dysfunction disappeared completely 1 yr after surgery
Gailloud[31], 2018	67	Longitudinally extensive myelopathy with parenchymal enhancement and flow-voids	Progressive lower extremity weakness and pain associated with sphincter dysfunction	Not mentioned	Improvement in his lower extremity pain and was otherwise unchanged
Niu et al[32], 2020	25	Multiple tortuous vascular flow voids in the lumbosacral canal from the conus medullaris to the S2 level with prominent edema and swelling of the spinal cord	Intermittent pain of the right lower limb	1 mo	The patient’s symptoms were completely relieved
Prieto et al[33], 2009	56	Total spine showed diffuse intramedullary hyperintensity with peripheral sparing between T8 and the conus medullaris, prominent perimedullary flow voids on the dorsal aspect of the cord	Lower extremity weakness and ascending numbness from his toes to his groin, urinary retention	9 mo	The patient’s lower extremity muscle strength was normal, and the deep tendon reflexes were bilaterally hyper-reflexic in both legs

MRI: Magnetic resonance imaging.