Justin M. Caplan, M.D., Mari Groves, M.D., Ignacio Jusue-Torres, M.D., Jennifer E. Kim, B.S., Jason Liauw, M.D., Ali Bydon, M.D., and Rafael J. Tamargo, M.D.

Johns Hopkins University School of Medicine, Department of Neurosurgery, Baltimore, Maryland

Abstract Spinal vascular lesions are rare and may be classified as a) dural arteriovenous fistulas (AVFs), b) arteriovenous malformations, or c) perimedullary AVFs. In this narrated video illustration, we present the case of a 71-year-old woman who presented with progressive bilateral lower extremity weakness and urinary retention who was diagnosed with a thoracic spinal perimedullary arteriovenous fistula. The diagnostic studies included a thoracic MRI and spinal angiogram. A multilevel thoracic laminoplasty was performed for microsurgical obliteration of the AVF. The techniques of intraoperative angiography, thoracic laminoplasty and microsurgical obliteration and resection of the AVF are reviewed.

Corresponding Author: Rafael J. Tamargo, M.D., Neurosurgery, 1800 Orleans Street, Zayed Tower, Suite 6115G, Baltimore, MD 21287. Email: rtamarg@jhmi.edu.