Object: The use of intraoperative angiography of the spine has become available to neurosurgeons as an adjunct in the management of complex spinal vascular malformations. These vascular malformations are rare, and the use of intraoperative angiography of the spine has not been well described. The authors report their recent experience with the use of this diagnostic modality.
Methods: Between 1995 and 1997, nine consecutive patients with type II or Type IV spinal arteriovenous malformations (AVMs) underwent intraoperative spinal angiography. The cervical spine was involved in three patients, the thoracic spine in five, and the thoracolumbar junction in one. In three patients, intraoperative spinal angiography revealed an unexpected finding (residual filling of the AVM). The results obtained using postoperative spinal angiography in all patients showed complete agreement with the intraoperative studies. No complications arose from obtaining the intraoperative spinal angiograms.
Conclusions: Intraoperative spinal angiography is technically feasible, can be performed safely, and has adequate resolution. It detects unexpected residual AVM in one-third of cases.