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<meta name="DC.Title" content="Spinal Dural Arteriovenous Fistulas: Clinical Experience with Endovascular Treatment as a Primary Therapy at 2 Academic Referral Centers" />
<meta name="DC.Identifier" content="10.3174/ajnr.A3522" />
<meta name="DC.Date" content="2013-10-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
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<meta name="DC.AccessRights" content="restricted" />
<meta name="DC.Description" content="BACKGROUND AND PURPOSE: Spinal dural arteriovenous fistulas are a rare entity that, if left untreated, can lead to considerable morbidity with progressive spinal cord symptoms. The aim of this study was to evaluate the clinical outcome of patients with spinal dural arteriovenous fistulas that were primarily treated with endovascular embolization.

MATERIALS AND METHODS: A retrospective review was performed of all patients from 1997–2010 who underwent treatment at 2 academic referral centers for a spinal dural arteriovenous fistula. Follow-up was performed by clinical examination, and functional status was measured by use of the Aminoff-Logue Disability Scale, McCormick classification grading, and mRS scores. The nonparametric Wilcoxon signed rank test was used to compare pretreatment and posttreatment Aminoff-Logue Disability Scale gait and micturition scores, McCormick classification grading, and mRS scores. P values &lt; .05 were considered significant.

RESULTS: A total of 38 patients were included. Five patients (2 endovascular, 3 surgical) were lost to follow-up and therefore were excluded from the analysis, 29 patients were initially treated from an endovascular approach (9 Onyx, 20 cyanoacrylate), and 4 patients were treated from a standard surgical approach. Five patients in the endovascular group subsequently underwent surgery for various reasons. The clinical improvements in the Aminoff-Logue Disability Scale gait and micturition scores, McCormick classification grading, and the mRS scores were statistically significant ( P &lt; .05, Wilcoxon signed rank test).

CONCLUSIONS: We conclude that endovascular treatment of spinal dural arteriovenous fistulas can result in good clinical outcomes. Surgery remains the treatment of choice when safe embolization of the proximal radicular draining vein cannot be obtained or because the shunting artery of the spinal dural arteriovenous fistula also supplies the anterior spinal, posterior spinal, or a radiculomedullary artery.

ALS
:   Aminoff-Logue Disability Scale
MC
:   McCormick classification
mRS
:   modified Rankin Scale
SDAVF
:   spinal dural arteriovenous fistula" />
<meta name="DC.Contributor" content="J.J. Gemmete" />
<meta name="DC.Contributor" content="N. Chaudhary" />
<meta name="DC.Contributor" content="A.E. Elias" />
<meta name="DC.Contributor" content="A.K. Toma" />
<meta name="DC.Contributor" content="A.S. Pandey" />
<meta name="DC.Contributor" content="R.A. Parker" />
<meta name="DC.Contributor" content="I. Davagnanam" />
<meta name="DC.Contributor" content="C.O. Maher" />
<meta name="DC.Contributor" content="S. Brew" />
<meta name="DC.Contributor" content="F. Robertson" />
<meta name="article:published_time" content="2013-10-01" />
<meta name="article:section" content="Interventional" />
<meta name="citation_title" content="Spinal Dural Arteriovenous Fistulas: Clinical Experience with Endovascular Treatment as a Primary Therapy at 2 Academic Referral Centers" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;Spinal dural arteriovenous fistulas are a rare entity that, if left untreated, can lead to considerable morbidity with progressive spinal cord symptoms. The aim of this study was to evaluate the clinical outcome of patients with spinal dural arteriovenous fistulas that were primarily treated with endovascular embolization.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;A retrospective review was performed of all patients from 1997–2010 who underwent treatment at 2 academic referral centers for a spinal dural arteriovenous fistula. Follow-up was performed by clinical examination, and functional status was measured by use of the Aminoff-Logue Disability Scale, McCormick classification grading, and mRS scores. The nonparametric Wilcoxon signed rank test was used to compare pretreatment and posttreatment Aminoff-Logue Disability Scale gait and micturition scores, McCormick classification grading, and mRS scores. &lt;i&gt;P&lt;/i&gt; values &amp;lt; .05 were considered significant.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;A total of 38 patients were included. Five patients (2 endovascular, 3 surgical) were lost to follow-up and therefore were excluded from the analysis, 29 patients were initially treated from an endovascular approach (9 Onyx, 20 cyanoacrylate), and 4 patients were treated from a standard surgical approach. Five patients in the endovascular group subsequently underwent surgery for various reasons. The clinical improvements in the Aminoff-Logue Disability Scale gait and micturition scores, McCormick classification grading, and the mRS scores were statistically significant (&lt;i&gt;P&lt;/i&gt; &amp;lt; .05, Wilcoxon signed rank test).&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;We conclude that endovascular treatment of spinal dural arteriovenous fistulas can result in good clinical outcomes. Surgery remains the treatment of choice when safe embolization of the proximal radicular draining vein cannot be obtained or because the shunting artery of the spinal dural arteriovenous fistula also supplies the anterior spinal, posterior spinal, or a radiculomedullary artery.&lt;/p&gt;" />
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<meta name="citation_doi" content="10.3174/ajnr.A3522" />
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<meta name="citation_firstpage" content="1974" />
<meta name="citation_lastpage" content="1979" />
<meta name="citation_author" content="J.J. Gemmete" />
<meta name="citation_author_institution" content="aFrom the Departments of Radiology (J.J.G., N.C., A.E.E.)" />
<meta name="citation_author_institution" content="bNeurosurgery (J.J.G., N.C., A.S.P., C.O.M.), University of Michigan Health Systems, Ann Arbor, Michigan" />
<meta name="citation_author" content="N. Chaudhary" />
<meta name="citation_author_institution" content="aFrom the Departments of Radiology (J.J.G., N.C., A.E.E.)" />
<meta name="citation_author_institution" content="bNeurosurgery (J.J.G., N.C., A.S.P., C.O.M.), University of Michigan Health Systems, Ann Arbor, Michigan" />
<meta name="citation_author" content="A.E. Elias" />
<meta name="citation_author_institution" content="aFrom the Departments of Radiology (J.J.G., N.C., A.E.E.)" />
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<meta name="twitter:title" content="Spinal Dural Arteriovenous Fistulas: Clinical Experience with Endovascular Treatment as a Primary Therapy at 2 Academic Referral Centers" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: Spinal dural arteriovenous fistulas are a rare entity that, if left untreated, can lead to considerable morbidity with progressive spinal cord symptoms. The aim of this study was to evaluate the clinical outcome of patients with spinal dural arteriovenous fistulas that were primarily treated with endovascular embolization.

MATERIALS AND METHODS: A retrospective review was performed of all patients from 1997–2010 who underwent treatment at 2 academic referral centers for a spinal dural arteriovenous fistula. Follow-up was performed by clinical examination, and functional status was measured by use of the Aminoff-Logue Disability Scale, McCormick classification grading, and mRS scores. The nonparametric Wilcoxon signed rank test was used to compare pretreatment and posttreatment Aminoff-Logue Disability Scale gait and micturition scores, McCormick classification grading, and mRS scores. P values &lt; .05 were considered significant.

RESULTS: A total of 38 patients were included. Five patients (2 endovascular, 3 surgical) were lost to follow-up and therefore were excluded from the analysis, 29 patients were initially treated from an endovascular approach (9 Onyx, 20 cyanoacrylate), and 4 patients were treated from a standard surgical approach. Five patients in the endovascular group subsequently underwent surgery for various reasons. The clinical improvements in the Aminoff-Logue Disability Scale gait and micturition scores, McCormick classification grading, and the mRS scores were statistically significant ( P &lt; .05, Wilcoxon signed rank test).

CONCLUSIONS: We conclude that endovascular treatment of spinal dural arteriovenous fistulas can result in good clinical outcomes. Surgery remains the treatment of choice when safe embolization of the proximal radicular draining vein cannot be obtained or because the shunting artery of the spinal dural arteriovenous fistula also supplies the anterior spinal, posterior spinal, or a radiculomedullary artery.

ALS
:   Aminoff-Logue Disability Scale
MC
:   McCormick classification
mRS
:   modified Rankin Scale
SDAVF
:   spinal dural arteriovenous fistula" />
<meta name="og-title" property="og:title" content="Spinal Dural Arteriovenous Fistulas: Clinical Experience with Endovascular Treatment as a Primary Therapy at 2 Academic Referral Centers" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/34/10/1974" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: Spinal dural arteriovenous fistulas are a rare entity that, if left untreated, can lead to considerable morbidity with progressive spinal cord symptoms. The aim of this study was to evaluate the clinical outcome of patients with spinal dural arteriovenous fistulas that were primarily treated with endovascular embolization.

MATERIALS AND METHODS: A retrospective review was performed of all patients from 1997–2010 who underwent treatment at 2 academic referral centers for a spinal dural arteriovenous fistula. Follow-up was performed by clinical examination, and functional status was measured by use of the Aminoff-Logue Disability Scale, McCormick classification grading, and mRS scores. The nonparametric Wilcoxon signed rank test was used to compare pretreatment and posttreatment Aminoff-Logue Disability Scale gait and micturition scores, McCormick classification grading, and mRS scores. P values &lt; .05 were considered significant.

RESULTS: A total of 38 patients were included. Five patients (2 endovascular, 3 surgical) were lost to follow-up and therefore were excluded from the analysis, 29 patients were initially treated from an endovascular approach (9 Onyx, 20 cyanoacrylate), and 4 patients were treated from a standard surgical approach. Five patients in the endovascular group subsequently underwent surgery for various reasons. The clinical improvements in the Aminoff-Logue Disability Scale gait and micturition scores, McCormick classification grading, and the mRS scores were statistically significant ( P &lt; .05, Wilcoxon signed rank test).

CONCLUSIONS: We conclude that endovascular treatment of spinal dural arteriovenous fistulas can result in good clinical outcomes. Surgery remains the treatment of choice when safe embolization of the proximal radicular draining vein cannot be obtained or because the shunting artery of the spinal dural arteriovenous fistula also supplies the anterior spinal, posterior spinal, or a radiculomedullary artery.

ALS
:   Aminoff-Logue Disability Scale
MC
:   McCormick classification
mRS
:   modified Rankin Scale
SDAVF
:   spinal dural arteriovenous fistula" />
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    <div class="highwire-article-citation highwire-citation-type-highwire-article node12658--5" data-node-nid="12658" id="top-node-12658--61536409900" data-pisa="ajnr;34/10/1974" data-pisa-master="ajnr;ajnr.A3522" data-apath="/ajnr/34/10/1974.atom" data-hw-author-tooltip-instance="highwire_author_tooltip"><div class="highwire-cite highwire-cite-highwire-article highwire-citation-jcore-article-title-complete clearfix has-author-tooltip highwire-citation-highwire-article-top-a">
  
  
      <div class="highwire-cite-overline"><span  class="highwire-cite-metadata-article-type highwire-cite-metadata">Research Article</span><span class="separator-pipe"></span><span  class="highwire-cite-metadata-art-cat highwire-cite-metadata"><span class="wrapper">Interventional</span></span></div>
  
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      <h1 class="highwire-cite-title" id="page-title">Spinal Dural Arteriovenous Fistulas: Clinical Experience with Endovascular Treatment as a Primary Therapy at 2 Academic Referral Centers</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">J.J. Gemmete</span>, <span class="highwire-citation-author" data-delta="1">N. Chaudhary</span>, <span class="highwire-citation-author" data-delta="2">A.E. Elias</span>, <span class="highwire-citation-author" data-delta="3">A.K. Toma</span>, <span class="highwire-citation-author" data-delta="4">A.S. Pandey</span>, <span class="highwire-citation-author" data-delta="5">R.A. Parker</span>, <span class="highwire-citation-author" data-delta="6">I. Davagnanam</span>, <span class="highwire-citation-author" data-delta="7">C.O. Maher</span>, <span class="highwire-citation-author" data-delta="8">S. Brew</span> and <span class="highwire-citation-author" data-delta="9">F. Robertson</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">October 2013,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">34 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(10) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1974-1979; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A3522 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-12658--61536409900" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">J.J. Gemmete </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Departments of Radiology (J.J.G., N.C., A.E.E.)</div><div class='author-affiliation'><span class='nlm-sup'>b</span>Neurosurgery (J.J.G., N.C., A.S.P., C.O.M.), University of Michigan Health Systems, Ann Arbor, Michigan</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=J.J.%2BGemmete%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Gemmete%20J&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AJ.J.%2BGemmete%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">N. Chaudhary </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Departments of Radiology (J.J.G., N.C., A.E.E.)</div><div class='author-affiliation'><span class='nlm-sup'>b</span>Neurosurgery (J.J.G., N.C., A.S.P., C.O.M.), University of Michigan Health Systems, Ann Arbor, Michigan</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=N.%2BChaudhary%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Chaudhary%20N&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AN.%2BChaudhary%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">A.E. Elias </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Departments of Radiology (J.J.G., N.C., A.E.E.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=A.E.%2BElias%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Elias%20A&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AA.E.%2BElias%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-3"><div class="author-tooltip-name">A.K. Toma </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>d</span>Neurosurgery (A.K.T.), National Hospital for Neurology & Neurosurgery, University College London Hospitals, London, United Kingdom</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=A.K.%2BToma%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Toma%20A&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AA.K.%2BToma%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-4"><div class="author-tooltip-name">A.S. Pandey </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Neurosurgery (J.J.G., N.C., A.S.P., C.O.M.), University of Michigan Health Systems, Ann Arbor, Michigan</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=A.S.%2BPandey%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Pandey%20A&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AA.S.%2BPandey%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-5"><div class="author-tooltip-name">R.A. Parker </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>e</span>Department of Biostatistics (R.A.P.), School of Public Health, University of Michigan, Ann Arbor, Michigan.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=R.A.%2BParker%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Parker%20R&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AR.A.%2BParker%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-6"><div class="author-tooltip-name">I. Davagnanam </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>c</span>Departments of Neuroradiology (I.D., S.B., F.R.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=I.%2BDavagnanam%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Davagnanam%20I&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AI.%2BDavagnanam%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-7"><div class="author-tooltip-name">C.O. Maher </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Neurosurgery (J.J.G., N.C., A.S.P., C.O.M.), University of Michigan Health Systems, Ann Arbor, Michigan</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=C.O.%2BMaher%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Maher%20C&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AC.O.%2BMaher%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-8"><div class="author-tooltip-name">S. Brew </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>c</span>Departments of Neuroradiology (I.D., S.B., F.R.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=S.%2BBrew%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Brew%20S&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AS.%2BBrew%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-9"><div class="author-tooltip-name">F. 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<p id="p-1"><strong>BACKGROUND AND PURPOSE:</strong> Spinal dural arteriovenous fistulas are a rare entity that, if left untreated, can lead to considerable morbidity with progressive spinal cord symptoms. The aim of this study was to evaluate the clinical outcome of patients with spinal dural arteriovenous fistulas that were primarily treated with endovascular embolization.</p>
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<p id="p-2"><strong>MATERIALS AND METHODS:</strong> A retrospective review was performed of all patients from 1997–2010 who underwent treatment at 2 academic referral centers for a spinal dural arteriovenous fistula. Follow-up was performed by clinical examination, and functional status was measured by use of the Aminoff-Logue Disability Scale, McCormick classification grading, and mRS scores. The nonparametric Wilcoxon signed rank test was used to compare pretreatment and posttreatment Aminoff-Logue Disability Scale gait and micturition scores, McCormick classification grading, and mRS scores. <em>P</em> values &lt; .05 were considered significant.</p>
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<p id="p-3"><strong>RESULTS:</strong> A total of 38 patients were included. Five patients (2 endovascular, 3 surgical) were lost to follow-up and therefore were excluded from the analysis, 29 patients were initially treated from an endovascular approach (9 Onyx, 20 cyanoacrylate), and 4 patients were treated from a standard surgical approach. Five patients in the endovascular group subsequently underwent surgery for various reasons. The clinical improvements in the Aminoff-Logue Disability Scale gait and micturition scores, McCormick classification grading, and the mRS scores were statistically significant (<em>P</em> &lt; .05, Wilcoxon signed rank test).</p>
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<p id="p-4"><strong>CONCLUSIONS:</strong> We conclude that endovascular treatment of spinal dural arteriovenous fistulas can result in good clinical outcomes. Surgery remains the treatment of choice when safe embolization of the proximal radicular draining vein cannot be obtained or because the shunting artery of the spinal dural arteriovenous fistula also supplies the anterior spinal, posterior spinal, or a radiculomedullary artery.</p>
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</div><div class="section glossary" id="glossary-1"><h2>ABBREVIATIONS:</h2>
<dl id="def-list-1"><dt id="def-item-1">ALS<span class="def-item-dt-sep"></span></dt><dd>Aminoff-Logue Disability Scale<span class="def-item-dd-sep"></span></dd><dt id="def-item-2">MC<span class="def-item-dt-sep"></span></dt><dd>McCormick classification<span class="def-item-dd-sep"></span></dd><dt id="def-item-3">mRS<span class="def-item-dt-sep"></span></dt><dd>modified Rankin Scale<span class="def-item-dd-sep"></span></dd><dt id="def-item-4">SDAVF<span class="def-item-dt-sep"></span></dt><dd>spinal dural arteriovenous fistula</dd></dl>
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        	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-volume highwire-cite-metadata">Vol. 34</span>, <span  class="highwire-cite-metadata-issue highwire-cite-metadata">Issue 10 </span><div  class="highwire-cite-metadata-pubdate highwire-cite-metadata">1 Oct 2013 </div></div>
      
      
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      <div class="highwire-cite-title">Spinal Dural Arteriovenous Fistulas: Clinical Experience with Endovascular Treatment as a Primary Therapy at 2 Academic Referral Centers</div>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">J.J.</span> <span class="nlm-surname">Gemmete</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">N.</span> <span class="nlm-surname">Chaudhary</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">A.E.</span> <span class="nlm-surname">Elias</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">A.K.</span> <span class="nlm-surname">Toma</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">A.S.</span> <span class="nlm-surname">Pandey</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">R.A.</span> <span class="nlm-surname">Parker</span></span>, <span class="highwire-citation-author" data-delta="6"><span class="nlm-given-names">I.</span> <span class="nlm-surname">Davagnanam</span></span>, <span class="highwire-citation-author" data-delta="7"><span class="nlm-given-names">C.O.</span> <span class="nlm-surname">Maher</span></span>, <span class="highwire-citation-author" data-delta="8"><span class="nlm-given-names">S.</span> <span class="nlm-surname">Brew</span></span>, <span class="highwire-citation-author" data-delta="9"><span class="nlm-given-names">F.</span> <span class="nlm-surname">Robertson</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Oct 2013, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">34 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(10) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1974-1979; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A3522 </span></div>
  
  
  
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      <div class="highwire-cite-title">Spinal Dural Arteriovenous Fistulas: Clinical Experience with Endovascular Treatment as a Primary Therapy at 2 Academic Referral Centers</div>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">J.J.</span> <span class="nlm-surname">Gemmete</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">N.</span> <span class="nlm-surname">Chaudhary</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">A.E.</span> <span class="nlm-surname">Elias</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">A.K.</span> <span class="nlm-surname">Toma</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">A.S.</span> <span class="nlm-surname">Pandey</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">R.A.</span> <span class="nlm-surname">Parker</span></span>, <span class="highwire-citation-author" data-delta="6"><span class="nlm-given-names">I.</span> <span class="nlm-surname">Davagnanam</span></span>, <span class="highwire-citation-author" data-delta="7"><span class="nlm-given-names">C.O.</span> <span class="nlm-surname">Maher</span></span>, <span class="highwire-citation-author" data-delta="8"><span class="nlm-given-names">S.</span> <span class="nlm-surname">Brew</span></span>, <span class="highwire-citation-author" data-delta="9"><span class="nlm-given-names">F.</span> <span class="nlm-surname">Robertson</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Oct 2013, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">34 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(10) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1974-1979; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A3522 </span></div>
  
  
  
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