Arteriovenous fistulas following vertebral fractures are probably very rare. We present a case with fistulous connection between arteries and veins within the fractured 12th thoracic vertebral body with retrograde venous drainage to perimedullary veins resulting in spinal venous hypertension and a cauda equina like symptomatology.
Pre-treatment 3D CT enabled us to puncture the venous pouch within the vertebra and deposit glue in the vertebral fistula. The procedure led to a complete occlusion of the fistula and relief of pain and neurological symptoms.
ZhangHHeMBoyongM: Thoracic spine extradural arteriovenous fistula: case report and review of literature. Surgical Neurology66, sup 1:18–23, 2006.
2.
KringsTGeibprasertS: Spinal dural arteriovenous fistulas: Am J Neuroradiol30: 639–648, 2009.
3.
WillinskyKTerBruggeK: Spinal epidural arteriovenous fistulas and venous approach to embolization. Am J Neuroradiol14: 812–817, 1993.
4.
Chul SuhDGon Choi Cbo SungK: Spinal osseous epidural arteriovenous fistula with multiple small arterial feeders converging to a round fistular nidus as a target of venous approach. Am J Neuroradiol25: 69–73, 2004.
5.
RodeschGLasjauniasP: Spinal cord arteriovenous shunts: from imaging to management. Eur J Radiol46: 221–232, 2003.
6.
SilvaNJrJanuelAC: Spinal epidural arteriovenous fistulas associated with progressive myelopathy. Report of four cases. J Neurosurg Spine6: 552–558, 2007.
7.
BaoY-HLingF: Classification and therapeutic modalities of spinal vascular malformations in 80 patients. Neurosurgery40: 75–81, 1997.
8.
GeibprasertSPereiraV: Dural arteriovenous shunts: a new classification of craniospinal epidural venous anatomical bases and clinical correlations. Stroke39: 2783, 2008.
9.
ThronA: Vascular anatomy of the spinal cord: neuroradiological investigations and clinical syndromes. Berlin, Germany: Springer Verlag. 1988.
10.
RodeschGHurthM: Classification of spinal cord arteriovenous shunts. Proposal for a reappraisal- the Bicêtre experience with 155 consecutive patients treated between 1981 and 1999. Neurosurgery51: 374–380, 2002.
11.
JelemaKTijssenCC: Spinal dural arteriovenous fistulas: an underdiagnosed disease-a review of patients admitted to the spinal unit of a rehabilitation center. J Neurol253:159–162, 2006.
12.
GjertsenØSchellhornTNakstadPH. Fluroscopy-guided sacroplasty. Special focus on preoperative planning from three dimensional computed tomography. Acta Radiol49:1042–1048, 2009.
