Spinal Cord Vascular Diseases
Conditions
Keywords
Spinal Arteriovenous Malformation, Spinal Arteriovenous Fistula
Brief summary
Spinal arteriovenous fistulas (AVFs) and arteriovenous malformations (AVMs) are complex neurosurgical lesions that are very challenging to manage. Spinal vascular malformations account for 3%-4% of all intradural spinal cord mass lesions. Over the last few decades our understanding of these lesions has dramatically increased thanks to neuroimaging technology (e.g. spinal angiography and indocyanine green angiography). Various treatment modalities including conservative observation, endovascular embolization, microsurgical resection, radiation therapy, and combined therapies have been reported. The treatment for these AVMs and AVFs depends on their location, the type of malformation, the area of the spine involved, and the condition of the patient at the time of treatment. Due to the rarity of these spinal vascular lesions, reports of their management and outcomes have been limited to small series and case reports. And the rates of obliteration and outcomes are not satisfactory, especially the spinal AVMs. Spinal vascular lesions are rare but represent a formidable challenge for the treating neurosurgeon.The purpose of this study is to establish multimodality treatment mode and evaluate the anatomical cure rate and functional preservation rate.
Detailed description
This is a multicenter, prospective, observational, registration study. There are nine centers involved in the study. The investigators set up a more detailed classification system for spinal vascular malformations. In accordance with inclusion criteria and exclusion criteria, this cohort study will include 380 samples in the study period of three years. According to the spinal angiography, the correct diagnosis and treatment strategy will be made. The minimally invasive surgical treatment methods and new techniques will be adopted such as spinal superselective angiography, preoperative embolization, intraoperative electrophysiological monitoring, intraoperative angiography, etc. All the enrolled patients will be visited a total of four times, postoperative day 1 and postoperative day 7, followed up postoperative 3 months and 12 months. The anatomical cure rate and spinal cord function will be assessed objectively. All data will be recorded in the network database platform.
Interventions
None listed
Sponsors
Beijing Tiantan Hospital
Beijing Tsinghua Chang Gung Hospital
Tianjin Medical University General Hospital
Peking University Third Hospital
Chinese PLA General Hospital
Beijing Hospital
General Hospital of Chinese Armed Police Forces
Beijing Haidian Hospital
China Rehabilitation Research Center
Hongqi Zhang, MD
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Healthy volunteers
No
Inclusion criteria
* patient diagnosed with spinal vascular diseases including * intradural arteriovenous malformation, * intradural arteriovenous fistula, * dural arteriovenous fistula, * extradural arteriovenous malformation, * paravertebral arteriovenous malformation, * paravertebral arteriovenous fistula, * cobbs' syndrome, * other spinal arteriovenous metameric syndromes involve the spinal cord. * patient not received surgical or interventional treatment before * patient with normal cardiac, renal and hepatic function * patient capable of understanding the content of the patient information / Informed Consent Form * patient willing and able to participate in the registry
Exclusion criteria
* patient received surgical treatment or interventional treatment before * patient is pregnant * patient allergic to iodine * patient unable to complete follow-up * patient with cerebral lesions * patient with other spinal lesions * patient with cardiac, renal or hepatic dysfunction
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change of the spinal cord function | 1 day before operation and 12 months postoperative | American Spinal Injury Association(ASIA) Score for evaluating the spinal cord function.Indexes (ASIA score) at baseline (1 day before operation) and 12 months follow-up will be collected, then the change from preoperative to 12 months follow-up will be assessed. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Anatomic obliteration rate | 3 months post operation | the anatomic obliteration rate is determined by angiography 3 months post operation. |
| American Spinal Injury Association(ASIA) Score | 1 week, 3 months, 6 months, 12 months post operation | — |
| Modified Aminoff & Logue's Scale (mALS) | 1 week, 3 months, 6 months, 12 months post operation | — |
| Modified Denis Pain and Numbness Scale (mDPNS) | 1 week, 3 months, 6 months, 12 months post operation | — |
| Incidence of perioperative complications | 1 week | — |
Countries
China
Contacts
Primary ContactHong Tao, MD
Outcome results
None listed