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

World J Clin Cases. 2021 Jul 16;9(20):5594-5604. doi: 10.12998/wjcc.v9.i20.5594.

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.

Keywords: Case report; Central nervous system vascular malformations; Diagnosis; Differential; Neurosurgery; Spinal degenerative disease; Spinal stenosis.

Publication types

  • Case Reports