Corpectomy: a direct approach to perimedullary arteriovenous fistulas of the anterior cervical spinal cord.

OBJECT: In this report, the authors describe five consecutive patients with cervical perimedullary arteriovenous fistulas (AVFs) that were successfully treated using a corpectomy performed via an anterior approach.

METHODS

Five patients with cervical perimedullary AVF underwent corpectomy via an anterior approach. There were four women and one man who ranged in age from 34 to 62 years (median 55 years). Four patients presented with subarachnoid hemorrhage and one with intramedullary hemorrhage. All five AVFs were located on the anterior surface of the cervical spinal cord and fed by the anterior spinal artery. All patients underwent an anterior approach with 1.5- or two-level corpectomy, opening of the dura mater, and coagulation of the fistula. After dural closure, an iliac bone graft was inserted. Four patients were treated by surgery alone and one patient by embolization and surgery. Postoperative angiography revealed complete disappearance of the AVF in all patients. Neurological status improved in two cases and stabilized in the other three. There were no surgery-related complications.

CONCLUSIONS

Safe and effective interruption of cervical AVFs can be accomplished by an anterior-approach corpectomy.