Microneurosurgery for Spinal Dural Arteriovenous Fistula- Operative Video.

[BACKGROUND AND INTRODUCTION] Spinal dural arteriovenous fistula (SDAVF) is a rare but curable condition. Microsurgery is a highly effective and readily affordable treatment modality.

[OBJECTIVE] We present a surgical video of SDAVF to demonstrate the operative nuances involved.

[SURGICAL TECHNIQUE] A 53-year-old wheelchair-bound man with spastic paraparesis for 1.5 years was found to have a SDAVF at L1/2 level with a single fistula point. During surgery, a L1-L2 laminectomy and durotomy revealed a dilated vein accompanying the nerve root exiting L1/2 foramen that showed early filling on indocyanine green (ICG) video angiography. This vein was occluded, and a segment of this vein was removed during surgery, which led to resumption of normal spinal cord perfusion.

[RESULTS] The patient showed gradual recovery of lower limb motor power and improved to assisted ambulation after 3 months.

[CONCLUSIONS] Surgery is a simple, effective, and cost-effective treatment option in SDAVF.