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Updated: Mar 25, 2026
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Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations
Published on: October 20, 2017
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Stereotactic radiosurgery for intramedullary spinal arteriovenous malformations
Maziyar A Kalani1, Omar Choudhri2, Iris C Gibbs3
1Department of Neurosurgery, Stanford University School of Medicine, 300 Pasteur Drive, Room R-225, Stanford, CA 94305, USA.
Summary
Stereotactic radiosurgery with CyberKnife offers a safe treatment for spinal cord arteriovenous malformations (AVM). This approach can obliterate or significantly reduce AVM size, providing a new option for patients with these rare lesions.
Area of Science:
- Neurosurgery
- Radiation Oncology
- Vascular Neurology
Background:
- Spinal cord arteriovenous malformations (AVM) are rare, potentially causing hemorrhage and ischemia.
- Limited effective treatment options exist for most spinal cord AVMs.
- Endovascular embolization and microsurgical resection are only suitable for select cases.
Purpose of the Study:
- To evaluate the efficacy and safety of CyberKnife stereotactic radiosurgery for intramedullary spinal cord AVM.
- To assess obliteration rates and volume reduction after radiosurgical treatment.
- To determine the impact of radiosurgery on patients with spinal cord AVM.
Main Methods:
- Retrospective analysis of 37 patients with intramedullary spinal cord AVM treated between 1997 and 2014.
- Treatment involved CyberKnife stereotactic radiosurgery with a mean marginal dose of 20.5Gy over a median of two sessions.
- Clinical and MRI follow-up were conducted annually, with spinal angiography repeated at 3 years.
Main Results:
- An overall obliteration rate of 19% was achieved.
- No post-treatment hemorrhagic events were reported.
- Significant volume reduction was observed in non-obliterated AVMs at 3-year follow-up.
Conclusions:
- CyberKnife stereotactic radiosurgery is a safe and effective treatment modality for intramedullary spinal cord AVM.
- Radiosurgery can lead to obliteration or significant shrinkage of these lesions.
- This treatment offers a viable option for patients with spinal cord AVM where other treatments are not feasible.
