Microscope-assisted endoscopic interlaminar ligation of spinal arteriovenous fistulas: technical note

Abstract

<jats:p>Spinal dural arteriovenous fistulas (SDAVFs) are the most common type of spinal arteriovenous malformations, and microsurgical ligation is the treatment modality most frequently used for these lesions. Developments in endoscopic techniques have made endoscopy an even less invasive alternative to routine microsurgical approaches in spine surgery, but endoscopic management of SDAVF or other intradural spinal lesions has not been reported to date.</jats:p> <jats:p>The authors describe the use of a microscope-assisted endoscopic interlaminar approach for the ligation of the proximal draining vein of an L-1 SDAVF in a 58-year-old man. A complete cure was confirmed by postoperative angiography. The postoperative course was uneventful, and short-term follow-up showed improvements in the patient's neurological function. The authors conclude that the endoscopic interlaminar approach with microscope assistance is a safe, minimally invasive, innovative technique for the surgical management of SDAVFs in selected patients.</jats:p>

Endovascular embolisation as minimally-invasive treatment for spinal dural arteriovenous fistulas — evaluation of long-term results

“…For this reason, some centres are implementing novel technologies (e.g. microscope-assisted endoscopic techniques in order to reduce the risk of complications) [17].…”

Current Indications for Spinal Endoscopic Surgery and Potential for Future Expansion

“…As for intradural lesion, case report revealed that full-endoscopic approach may be a potential alternative for the resection of intradural extramedullary tumor 62 or the ligation of spinal dural arteriovenous fistula. 63 However, indications are limited to small size tumors without significant nerve roots or spinal cord compression. It is challenging to debulk and detatch the large-size tumor with full-endoscopic technique under limited visualization.…”