Long-term follow-up and outcome in patients treated for spinal dural arteriovenous fistula

Clinical outcome was examined in 21 patients treated for spinal dural arter iovenous fistula after 5-50 months. We compared the neurological condition (motor function, pain, sensory disturbance, vegetative dysfunction) and Bar thel index before and after fistula occlusion. Neurological impairment was assessed as improved, unchanged, or deteriorated. All patients initially sh owed paraparesis of varying degree, and a sensory loss with a defined level in 81% before treatment. The greatest postoperative change that we measure d was in motor activity (67% improved), and the most important deterioratio n was in male potency (28% deteriorated). We observed unchanged or absent s ymptoms in pain in 71% of our patients. We were thus able not only to stop but even to reverse the progression of symptoms and the degree of disabilit y. On average, neurological symptoms stabilized within 1 year. The results of this study confirm that spinal dural arteriovenous fistula should be tre ated as early as possible after diagnosis.