Spinal Dural Arteriovenous Fistula
Conditions
Keywords
spinal dural arteriovenous fistula, spinal arteriovenous malformation, spinal AVF, sdAVF, international, multicenter, registry
Brief summary
Given the lack of large multicenter datasets in the context of Spinal arteriovenous fistula, the strength of the evidence surrounding this rare disease is limited. SPIDER hence aims to address that by compiling patient-level data from centers all around the world.
Detailed description
Type 1 or dural spinal arteriovenous fistulas (SDAVFs) are the most common spinal vascular malformation but remain frequently underdiagnosed due to their insidious onset and nonspecific clinical presentation. Delayed diagnosis is common and often results in progressive, and sometimes irreversible, myelopathy. Despite advances in imaging and treatment, there remains significant variability in diagnostic timelines, treatment strategies (endovascular, surgical, or combined), and reported outcomes across institutions. Existing literature is largely limited to single-center retrospective series or small cohorts, often underpowered to evaluate predictors of outcome, recurrence, and the impact of diagnostic delay. Furthermore, direct comparisons between treatment modalities and long-term functional outcomes using standardized clinical scales are limited. The SPIDER registry is designed to address these gaps by creating the largest international, multicenter dataset of patients with spinal dural AVFs. By pooling de-identified data from high-volume centers worldwide, this study aims to provide robust, generalizable evidence to inform clinical decision-making and optimize patient outcomes.
Interventions
None listed
Sponsors
Study design
Eligibility
Inclusion criteria
* Type 1 spinal dural arteriovenous fistula, confirmed on imaging * Surgically or endovascularly treated * At least 1 available primary outcome
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Treatment success | Recorded at the end of the embolization or surgery. | Complete surgical/endovascular obliteration of the fistula |
| Recurrence | Time-to-event Outcome Measures. Estimated period of time over which the event is assessed: on average 1.5 years after surgery. | Fistula recurrence |
| Status of symptoms at last clinical follow-up | Time-to-event Outcome Measures. Estimated period of time over which the event is assessed: on average 1.5 years after surgery. | Improved, unchanged, or worsened pain, sensory, and motor symptoms |
| Modified Aminoff-Logue Scale | Time-to-event Outcome Measures. Estimated period of time over which the event is assessed: on average 1.5 years after surgery. | Gait and bowel/bladder score |
| Modified Rankin Scale | Time-to-event Outcome Measures. Estimated period of time over which the event is assessed: on average 1.5 years after surgery. | Measure of functional independence |
| Mortality | Time-to-event Outcome Measures. Estimated period of time over which the event is assessed: on average 1.5 years after surgery. | — |
Countries
United States