Multiple gigantic arteriovenous malformations with destruction of lumbar vertebral bodies - A case report

Study Design. This case report describes a patient with massive intramuscul ar and paravertebral arteriovenous malformations with destruction of verteb ral bodies. Objectives. To demonstrate successful interbody fusion of the involved vert ebral bodies after embolization for arteriovenous malformation. Summary of Background Data. Although arteriovenous malformations in the spi nal cord are well documented in the literature, arteriovenous malformation in the paravertebral and iliopsoas muscles with destruction of Vertebral bo dies is an extremely rare clinical condition. Methods. After careful investigation with angiography, the arteriovenous ma lformations were managed with embolization, and the scoliosis caused by the collapsed vertebral bodies was managed surgically by anterior spinal fusio n with segmental spinal instrumentation. Results. The patient's scoliosis caused by vertebral collapse was corrected by surgery, and good alignment of the lumbar spine was achieved. The preop eration pain had subsided completely by follow-up assessment 1 year and 10 months after fusion. However, the arteriovenous malformations stilt remaine d. Careful observation should be maintained continuously in the coming days . Conclusion. In arteriovenous malformations with destruction of the vertebra l bodies, embolization and spinal fusion with segmental instrumentation may be necessary to relieve pain and prevent the progression of spinal deformi ty. Arteriovenous malformation should be considered in the diagnostic evalu ation of a patient who has experienced vertebral collapse with no Inflammat ory signs.