SPINAL ARTERIOVENOUS-MALFORMATIONS - HEALTH-RELATED QUALITY-OF-LIFE AFTER EMBOLIZATION

The overall function, pain and mood disturbances of 19 patients with s pinal arteriovenous malformations (AVM), treated by embolization betwe en 1983 and 1988, were studied. The after-care had taken place in diff erent hospitals and clinics. The patients demonstrated markedly poorer physical function (Sickness Impact Profile) and poorer psychological well-being (Mood Adjective Check List) than control population samples and a comparison group of traumatic incomplete paraplegics. The degre e of decrease of mood levels implied possible depressive disorder (Hos pital Anxiety and Depression scale) in 16% of the patients and differe d from that of the paraplegic comparison group. Furthermore, the AVM p atients reported more disturbance of their family and social life than the paraplegics and they were more seldom gainfully employed. Patient s recorded a wide range of pain scores, significantly worse than the p araplegics, and their pain was closely linked to overall quality of li fe (QL) perception. The QL scores were consistently related to all mea sures of functional and emotional status, but no connection with neuro logical lesion levels or medical complications was found. Specialised programmes after embolization, such as those offered in spinal injury units, would appear appropriate for AVM patients to improve their phys ical functioning and to provide a more rewarding social life.