Condition Overview
A spinal AVM is an abnormal tangle of blood vessels that disrupts the normal circulation of blood. Because the oxygenated blood skips the capillaries, the surrounding nerves can be deprived of oxygen, leading to progressive tissue death and neurological dysfunction.
A sudden rupture can lead to bleeding into the spinal cord, causing rapid-onset paralysis and severe back pain.
Symptoms & Presentation
Symptoms typically manifest between ages 20 and 30, though dural fistulas (Type I) often appear later in life.
Progressive leg weakness, numbness, back pain, and difficulty walking.
Loss of bladder/bowel control, sensory loss, and sudden acute pain (if bleeding occurs).
Diagnostics: The Gold Standard
Accurate mapping of the vascular architecture is critical for surgical planning.
Primary screening tool. Typically reveals "flow voids" or dilated vascular channels around the cord.
An invasive procedure where dye is injected into specific arteries. This identifies the precise "feeder" vessels and the "nidus" (tangle) of the AVM.
Classification (Types I–IV)
Most common. Located on the dural surface; typically seen in older males.
Located inside the spinal cord tissue (intramedullary).
Extensive and complex; involves multiple feeding arteries and vertebral bodies.
Direct fistula located on the surface of the cord (subarachnoid space).
Treatment & Prognosis
Management Options
- 1
Endovascular Embolization: Minimally invasive. A catheter delivers a "glue" or coil to block the feeding artery.
- 2
Surgical Resection: A neurosurgeon performs a laminectomy and removes the AVM directly.
- 3
Stereotactic Radiosurgery: Focused radiation used to gradually shrink the AVM over months or years.
Without treatment, 50% to 70% of patients develop permanent disability within 3 to 5 years. Timely intervention can halt or partially reverse symptoms, depending on the baseline nerve damage.
