Intraoperative spinal angiography

Object. The use of intraoperative angiography of the spine has become avail able to neurosurgeons as an adjunct in the management of complex spinal vas cular malformations. These vascular malformations are rare, and the use of intraoperative angiography of the spine has not been well described. The au thors report their recent experience with the use of this diagnostic modali ty. Methods. Between 1995 and 1997, nine consecutive patients with type II or T ype IV spinal arteriovenous malformations (AVMs) underwent intraoperative s pinal angiography. The cervical spine was involved in three patients, the t horacic spine in five, and the thoracolumbar junction in one. In three pati ents, intraoperative spinal angiography revealed an unexpected finding (res idual filling of the AVM). The results obtained using postoperative spinal angiography in all patients showed complete agreement with the intraoperati ve studies. No complications arose from obtaining the intraoperative spinal angiograms. Conclusions. Intraoperative spinal angiography is technically feasible, can be performed safely, and has adequate resolution. It detects unexpected re sidual AVM in one-third of cases.