Rapidly Progressive Paraplegia Resulting from Latent Cervical Dural Arteriovenous Fistula After Lumbar Surgery: A Case Report

JBJS Case Connect. 2022 Jan 20;12(1). doi: 10.2106/JBJS.CC.21.00561.

Abstract

Case: A 68-year-old woman developed symptoms of acute paraplegia due to an occult cervical dural arteriovenous fistula (DAVF) after a minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF). She was subsequently diagnosed by angiography and treated with vascular embolization. A 2-year follow-up showed that the patient's upper limb muscle strength returned to normal, and the lower limb muscle strength partially improved with remnant motor dysfunction.

Conclusion: For patients with symptoms of nerve injury inconsistent with the spinal surgery site, a possibility of DAVF should be considered, and related investigations should be performed. Once diagnosed, active treatment is required.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Central Nervous System Vascular Malformations* / complications
  • Central Nervous System Vascular Malformations* / diagnostic imaging
  • Female
  • Humans
  • Lumbar Vertebrae / surgery
  • Minimally Invasive Surgical Procedures / methods
  • Paraplegia / etiology
  • Spinal Fusion* / adverse effects
  • Spinal Fusion* / methods