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CyberKnife Radiosurgery for Spinal Intramedullary Arteriovenous Malformations: A Single-Center Experience
Tomoya Suzuki1, Kenji Kagawa2, Kengo Sato2
1Department of Neurosurgery, The Jikei University School of Medicine, Tokyo, Japan.
World Neurosurgery
|March 20, 2023
Summary
Stereotactic radiotherapy (SRT) shows promise for treating intramedullary spinal arteriovenous malformations (ISAVM), especially when other treatments are not feasible. This study found no hemorrhages after SRT, suggesting it is a safe option for ISAVM management.
Area of Science:
- Neurosurgery
- Radiation Oncology
- Vascular Neurology
Background:
- Intramedullary spinal arteriovenous malformations (ISAVM) are rare, complex vascular lesions affecting the spinal cord.
- Standard treatments like microsurgery and endovascular therapy carry high risks for certain ISAVM cases.
- Stereotactic radiotherapy (SRT) is considered an alternative for high-risk ISAVM patients.
Purpose of the Study:
- To evaluate the safety and efficacy of CyberKnife SRT for treating ISAVM.
- To assess outcomes in patients with ISAVM who underwent SRT.
Main Methods:
- Retrospective review of 10 consecutive ISAVM patients treated with CyberKnife SRT.
- Data collected from January 2011 to March 2022 at a single institution.
Main Results:
- No hemorrhages occurred post-SRT in any patient.
- One patient developed delayed neurological impairment attributed to venous congestion.
- No radiation myelopathy was observed; one patient showed nidus volume reduction without neurological improvement.
Conclusions:
- SRT appears to be a feasible and safe option for ISAVM, particularly for complex lesions unsuitable for conventional treatments.
- Absence of hemorrhagic events, even without radiological changes, supports SRT's safety profile.
- Further research with larger cohorts and longer follow-up is necessary to confirm SRT's long-term efficacy for ISAVM.
