Microneurosurgery for Spinal Dural Arteriovenous Fistula- Operative Video.

BACKGROUND AND

INTRODUCTION

Spinal dural arteriovenous fistula (SDAVF) is a rare but curable condition. Microsurgery is a highly effective and readily affordable treatment modality.

OBJECTIVE

We present a surgical video of SDAVF to demonstrate the operative nuances involved.

SURGICAL TECHNIQUE: A 53-year-old wheelchair-bound man with spastic paraparesis for 1.5 years was found to have a SDAVF at L1/2 level with a single fistula point. During surgery, a L1-L2 laminectomy and durotomy revealed a dilated vein accompanying the nerve root exiting L1/2 foramen that showed early filling on indocyanine green (ICG) video angiography. This vein was occluded, and a segment of this vein was removed during surgery, which led to resumption of normal spinal cord perfusion.

RESULTS

The patient showed gradual recovery of lower limb motor power and improved to assisted ambulation after 3 months.

CONCLUSIONS

Surgery is a simple, effective, and cost-effective treatment option in SDAVF.