Objective To summarize the experience in surgical treatment of spinal dural arteriovenous fistula (SDAVF).Methods The clinical and following-up date from 9 patients with SDAVF were analyzed retrospectively.Results Draining vein between fistula and spinal cord was interrupted by hemilaminectomy or subtotal laminectomy approach in 6 patients and by endovascular embolizationin 3.Complete disappearance of SDAVF was confirmed in 6 surgical patients who received postoperative spinal angiography.The paramedullary tortuous flow voids fully disappeared in all patients on postoperative T2 weighted MRI.The patients were followed up for 3 months to 5 years,which showed a complete recovery in 4 patients,improvement in 3 cases,and deterioration in 1 case.All patients were no recurrence during follow up.Conclusion SDAVF is insidious in onset,which is easily misdiagnosed and has a poor prognosis without treatment.Early treatment can produce a good outcome.%目的 总结硬脊膜动-静脉瘘的临床诊治经验.方法 回顾性分析9例硬脊膜动-静脉瘘患者的临床资料.结果 本组患者经半或次全椎板切除入路手术6例,经血管内栓塞3例.6例手术患者术后复查脊髓血管造影显示瘘口完全闭塞.3例栓塞者复查脊髓MRI示髓周血管流空信号影全部消失.8例患者获随访3个月-5年,4例患者症状完全消失,3例改善,1例加重,所有随访患者复查DSA示瘘口无再通.结论 硬脊膜动-静脉瘘起病隐匿,易漏诊、误诊,自然病程预后差,应积极干预,疗效理想.
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