J Korean Orthop Assoc.  2009 Apr;44(2):261-265.

Giant Thoracic Spinal Arteriovenous Fistula with Cord Compression: A Case Report

• Park SR
• Cho KJ
• Yun YH
• Lee M
• Kang SB
• Pyun HW
• Jung SJ

Abstract

A spinal arteriovenous fistula is a rare vascular disease that is characterized by abnormal connections between the vertebral artery or its branches and the neighboring veins. Bruit and back pain are common symptoms related to the fistula. Spinal cord dysfunction can also occur as a result of blood flow steal, venous hypertension, or mechanical compression of the nerve roots and spinal cord. We report a huge arteriovenous fistula in the spinal canal at the thoracic vertebra, which was characterized by a large azygous vein connected to the epidural vein causing osteolysis on the vertebral body and spinal cord compression symptoms. Staged embolization was performed using 80 coils.

Keyword

Arteriovenous fistula; Azygous vein; Cord compression

MeSH Terms

Arteriovenous Fistula
Back Pain
Fistula
Hypertension
Osteolysis
Spinal Canal
Spinal Cord
Spinal Cord Compression
Spine
Vascular Diseases
Veins
Vertebral Artery

Figure

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  Fig. 1 CT angiography shows tortuous dilated epidural veins (arrow) which drain to markedly enlarged azygous vein (arrowheads).

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  Fig. 2 T-spine MRI shows huge dilated azygous and epidural veins causing osteolysis at the vertebral body and compressing spinal cord (Arrow). Preoperative thoracic spinal angiographies shows.

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  Fig. 3 A 63-year-old woman had progressive lower enlarged feeding arteries connecting markedly dilated azygous vein. (A, B) After embolization, AP (C) and lateral (D) angiographies depict massive coil packing (arrow) in azygous vein and near total obliteration of shunt flow.

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