LAUSR

OBJECT Spinal dural arteriovenous fistula (SDAVF) is a rare spinal vascular malformation which can cause permanent neurological dysfunction. The purpose of this study was to investigate the relationship between the clinical and imaging characteristics of SDAF and its prognosis. METHODS All patients diagnosed with SDAVF and hospitalized in our hospital from February 2004 to September 2018 were retrospectively recruited. The clinical and imaging data of these patients were collected, and then, a subgroup analysis was performed to find the association between clinical and imaging characteristics of SDAF and its prognosis. RESULTS A total of 79 patients were included in the analysis. The median age of the patients was 59 years, with males had a predominant morbidity (84.4%). The mean duration of symptoms was 7 months, and most patients had more than two symptoms before hospitalization (n = 43, 44.4%). The fistula mainly occurred in the lower thoracic (n = 40, 50.6%), followed by lumbar (n = 18, 22.8%) and upper thoracic (n = 16, 20.3%). Of 58 patients with MRI images available, 45 (77.6%) were identified with high T2WI signal in the spinal cord, and 51 (87.9%) with T2WI flow voids on spinal surface. Multivariate logistic regression analysis found that preoperative ALS scores were associated with postoperative function improvement after adjustment for gender, age, and duration of symptoms (p=0.013, OR=1.375, 95% CI: 1.07-1.77). CONCLUSIONS Preoperative ALS scores are associated with improved prognosis in patients with SDAVF. Both surgical ligation and endovascular embolization can improve functional outcomes and delay disease progression.