Types of Spinal Vascular Malformations
A spinal arteriovenous malformation (AVM) is an abnormal tangle of blood vessels in or around the spinal cord, where arteries connect directly to veins. The most common type in adults, a spinal dural arteriovenous fistula, causes gradual leg weakness and numbness that is often mistaken for other conditions.
Spinal vascular malformations are complex conditions requiring specialized neurosurgical and neuroradiological care. Medically reviewed by Dr Jaydev Panchawagh, MS (General Surgery), MCh (Neurosurgery), Consultant Neurosurgeon, Pune (Last reviewed: [DD Month 2026]). For educational purposes only; individual outcomes vary and this content is not a substitute for personal medical advice.
A small abnormal connection in the covering of a nerve root, usually in the lower thoracic spine, that raises pressure in the veins of the cord. Usually affects middle-aged and older men.
A tangle of vessels within the spinal cord that can bleed.
Connections on the surface of the cord and rarer combined types.
Symptoms
Clinical presentation typically involves progressive neurological signs:
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Motor deficits: Gradual weakness, stiffness, or heaviness in the legs.
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Sensory issues: Numbness or tingling in the legs, sometimes rising up the body.
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Pain: Back pain.
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Autonomic symptoms: Bladder, bowel, or sexual problems.
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Exacerbation & Haemorrhage: Symptoms that worsen with exercise or standing — or, with bleeding, sudden severe back pain and weakness.
Sudden severe back pain with new weakness or numbness of the legs, or new loss of bladder or bowel control, needs emergency hospital assessment.
Diagnosis
Accurate diagnosis combines advanced neuroimaging with specialized vascular studies:
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MRI of the spine: Shows swelling of the spinal cord and enlarged vessels on its surface.
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Spinal angiography: Dye injected into the spinal arteries shows exactly where the abnormal connection is; it confirms the diagnosis and plans treatment.
Treatment Options
The abnormal connection is found and closed through a small opening of the spine, under the microscope. Read about AVM resection.
The abnormal vessel is closed from inside with a glue-like material delivered through a catheter, when the anatomy is suitable.
Treatment aims to stop further damage to the spinal cord. Leg strength and walking often improve after treatment, particularly when it is done before damage is long-standing.
Microsurgery and embolisation both aim to close the abnormal connection; the choice depends on its location and anatomy on angiography. The choice should follow the anatomy of your condition, your own circumstances — your health, your work, and what matters to you in recovery — and the advice of your neurosurgeon after examining you and reviewing your scans.
Questions to Ask Your Neurosurgeon
These are the questions patients most often search for after a spinal AVM or dural fistula is found:
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Malformation type & location: What type of vascular malformation is it, and where is it?
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Angiography findings: Has the angiogram identified the exact connection?
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Treatment modality: Is surgery or embolisation better in my case, and why?
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Expected recovery: Which symptoms are likely to improve after treatment?
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Follow-up verification: How will we check that it is fully closed?
Unless there is an emergency, spine surgery is a planned decision. Seeking a second opinion from a qualified spine surgeon or neurosurgeon before deciding is entirely appropriate.
Frequently Asked Questions
General information only. Please consult a qualified spine surgeon or neurosurgeon for advice about your situation.
A spinal arteriovenous malformation is an abnormal connection between arteries and veins in or around the spinal cord. It raises pressure in the veins or can bleed, damaging the cord and causing weakness, numbness, and bladder problems.
It is the most common spinal vascular malformation in adults: a small abnormal artery-to-vein connection in the covering of a nerve root, usually in the lower thoracic spine. It causes gradually worsening leg weakness, numbness, and bladder symptoms.
Its symptoms develop slowly and resemble more common conditions such as spinal stenosis or nerve disease. MRI changes can be subtle, and spinal angiography is needed to confirm it.
MRI of the spine shows swelling of the cord and abnormal vessels. Spinal angiography, in which dye is injected into the spinal arteries, confirms the diagnosis and shows the exact location for treatment.
Yes, in most cases the abnormal connection can be closed by microsurgery or endovascular embolisation. Treatment stops further damage, and many patients regain some strength and walking ability.
Spinal vascular malformations are treated by neurosurgeons and interventional neuroradiologists working together. Dr Jaydev Panchawagh—MBBS (B.J. Medical College, Pune), MS in General Surgery (KEM Hospital, Pune), and MCh in Neurosurgery (Seth GS Medical College and KEM Hospital, Mumbai)—is a consultant neurosurgeon in Pune (102, Bhagyatara Society, Erandwane, Pune, Maharashtra 411004; Tel: +91-9011333841) who assesses and treats spinal AVMs and dural fistulas.
