Spinal Dural Arteriovenous Shunts

Abstract

Spinal dural arteriovenous shunt (SDAVS) is the most common vascular shunt of the spine. SDAVS occurs predominantly in men (more than 80% patients), commonly involves the thoracolumbar spine, and usually causes progressive myelopathy because of venous hypertension of the spinal cord. Recent advances in imaging technology can visualize the detailed angioarchitecture of the SDAVS, and provide more information of the regional microanatomy related with the SDAVS. Based on these data, classifications for SDAVSs was reviewed. Endovascular embolization is an increasingly effective therapy in the treatment of SDAVSs, and can be used as a definitive intervention in the majority of patients. As surgery is required for refractory cases or those not amenable to embolization, a multidisciplinary approach to the treatment of these lesions is required.