多种治疗方法最大限度地改善脊柱长脉静脉
A J Gauden1, B Gu2, S Han3
1Department of Neurosurgery, Stanford University School of Medicine, 453 Quarry Road, Palo Alto, CA 94304, USA.
概括
脊柱长脉静脉 (sDAVF) 可以通过手术或栓塞有效治疗,导致高治愈率和改善患者功能. 多模式治疗是治疗这些罕见的脊髓血管形的关键.
科学领域:
- 神经外科
- 血管神经学
- 干预性放射学
背景情况:
- 脊柱硬性动脉静脉 (sDAVF) 是最常见的脊柱血管形,通常会导致骨髓病和.
- 尽管存在微手术和内血管选择,但对sDAVF的最佳治疗策略仍在争论中.
研究的目的:
- 在单一机构评估脊柱长脉静脉的多模式治疗方法的有效性.
- 评估治疗后的放射性治愈率和功能结果.
主要方法:
- 在1998年至2021年期间对47名sDAVF治疗的患者进行了回顾.
- 数据提取包括表现症状,持续时间,血管学特征和治疗方式 (微手术或栓塞).
- 通过血管图和MRI改善来定义治愈;使用阿米诺夫- 洛格尺度 (ALS) 评估功能结果.
主要成果:
- 在初始治疗后达到84.4%和最终治疗后达到97.9%的放射性治愈率.
- 微手术切除 (84. 4% 的初始治愈) 和内血管栓塞 (86. 7% 的初始治愈) 均显示出高疗效.
- 血管内栓塞可实现100%的治愈,作为先前失败的额外治疗,而手术可实现80%的治愈.
- 在治疗后的ALS步行 (p=0. 0003) 和微观度 (p=0. 057) 评分中观察到显著的功能改善.
结论:
- 当患者经过仔细选择时,手术和内血管治疗都能对sDAVF治愈和功能改善具有很高的效果.
- 多模式治疗策略对于有效管理脊柱长脉静脉是至关重要的.
- 需要进一步的研究来确定患者和放射学因素,以指导初始治疗方式的选择.
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