1470. Adult Spinal Arteriovenous Malformations: Natural history and a multicenter study of short-term surgical outcomes
Authors: Nauman Chaudhry, MD; Abhiraj Bhimani, BS; Mandana Behbahani, MD; Ankit Mehta, MD (Chicago, IL)
Spinal Arteriovenous Malformations (SAVMs) are a very rare and complex spinal cord pathology that require high clinical acumen to diagnose and treat. Management includes both non-operative and operative paradigms. A review of the literature yields a paucity of data regarding the surgical outcomes of SAVMs, with the majority of data limited to single center outcomes and/or small sample sizes. The purpose of this study was to use a multi-institutional international database to study the natural history of SAVMs.
The study used American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database to select patients that underwent laminectomy for surgical excision a spinal AVM. The study analyzed demographics, comorbidities, multiple 30-day postoperative outcomes for the patients undergoing the procedure between 2008-2017 were measured.
196 patients were studied, with the demographic consisting of 65.8% males and 34.2% females. A majority of cases were in the thoracic region (53.6%), followed by thoracolumbar (31.6%) and cervical (14.8%) regions. The mean age was 57.4 years and 52.5% patients consisted of ASA class 3-5 before the operation. The mean operation time was 215 minutes, with a significantly lower operative time for thoracic AVMs (195.6 minutes) when compared to cervical (266.6 minutes) and thoracolumbar (223.7 minutes). The mean length of hospital stay was 6.4 days. Patients had a 6.6% readmission rate and a 4.6% reoperation rate within 30 days.
This study shows a multinational natural history of SAVMs and 30-day postoperative outcomes, encompassing a epidemiology and outcomes from a diversity of institutions and a larger sample size than previously published works. Future multicenter studies comparing neurological outcomes and long-term follow-up are required to better depict the natural history of spinal AVMs and surgical outcomes.