Multiple Gigantic Arteriovenous Malformations With Destruction of Lumbar Vertebral Bodies

A Case Report

Abstract

Study Design. 

This case report describes a patient with massive intramuscular and paravertebral arteriovenous malformations with destruction of vertebral bodies.

Objectives. 

To demonstrate successful interbody fusion of the involved vertebral bodies after embolization for arteriovenous malformation.

Summary of Background Data. 

Although arteriovenous malformations in the spinal cord are well documented in the literature, arteriovenous malformation in the paravertebral and iliopsoas muscles with destruction of vertebral bodies is an extremely rare clinical condition.

Methods. 

After careful investigation with angiography, the arteriovenous malformations were managed with embolization, and the scoliosis caused by the collapsed vertebral bodies was managed surgically by anterior spinal fusion with segmental spinal instrumentation.

Results. 

The patient’s scoliosis caused by vertebral collapse was corrected by surgery, and good alignment of the lumbar spine was achieved. The preoperation pain had subsided completely by follow-up assessment 1 year and 10 months after fusion. However, the arteriovenous malformations still remained. Careful observation should be maintained continuously in the coming days.

Conclusion. 

In arteriovenous malformations with destruction of the vertebral bodies, embolization and spinal fusion with segmental instrumentation may be necessary to relieve pain and prevent the progression of spinal deformity. Arteriovenous malformation should be considered in the diagnostic evaluation of a patient who has experienced vertebral collapse with no inflammatory signs.