A vascular malformation is an abnormal collection or tangle of blood vessels on, in, or near the spinal cord. Two of the most common types are arteriovenous malformations (AVMs) and arteriovenous fistulas (AVFs).
AVMs are caused when oxygen-rich blood, which normally enters your spinal cord through arteries and blood vessels, bypasses the blood vessels, or capillaries, and passes directly into the veins. The spinal cord doesn’t receive enough oxygen and causes spinal tissues to deteriorate or die. Sometimes the spinal AVM can rupture, causing bleeding in the spinal cord. As AVMs grow, they may put pressure on the spinal cord.
AVFs account for 70 percent of all spinal vascular malformations and usually appear in the thoracic (mid back) spine near the nerve root. They are caused by an abnormal connection between arteries and the tough covering over the spinal cord and a draining vein. AVFs create congestion in the veins and hypertension, resulting in decreased blood flow through the organs, oxygen depletion, and swelling of the spinal cord.
At UPMC we treat several treatments for vascular malformations on the spine. Depending on the location of the malformation, surgeons may recommend resection surgery, endovascular embolization, or a combination of both. Surgery involves the removal of the malformation from the surrounding tissue. In endovascular embolization, the surgeon threads a long thin tube into an artery in the leg through the blood vessels to the spinal cord using x-ray imaging. A substance is injected to block the artery and reduce blood flow to the malformation.
To diagnose spinal vascular malformations, the doctor will conduct a full physical examination and medical history. Patients with the more common AVF typically have different symptoms than those with AVMs. AVFs are more common in men and usually occur between the ages of 50 and 80. Patients with AVMs are typically younger than 30 years old.
Symptoms of spinal AVMs may include:
Symptoms of spinal AVFs may include:
Angiography is used to pinpoint the location and characteristics of the feeding arteries and draining veins. CT scan can show the feeding arteries and draining veins in greater detail. An MRI may provide information about the exact location of the malformation, which helps in determining treatment.
At UPMC we treat vascular malformations with endovascular embolization, surgical removal (resection), or a combination of both, depending on the size and location of the abnormal blood vessels. Endovascular embolization is a technique that reduces blood flow to the area. The neurosurgeon will inject a glue-like substance to block the blood vessels and reduce blood flow into the malformation.
Embolization may be done prior to microsurgical resection. Once the vascular malformation has been removed from circulation, surgical removal becomes significantly easier.
How can we help you?
Schedule anappointment >
Ask a question >
Request our expertopinion >
1-877-986-9862(within the U.S.)
Affiliated with the University of Pittsburgh Schools of the Health Sciences
Supplemental content provided by
A.D.A.M. Health Solutions. All rights reserved.
For help in finding a doctor or health service that suits your needs, call the UPMC Referral Service at 412-647-UPMC (8762) or 1-800-533-UPMC (8762). Select option 1.
UPMC is an equal opportunity employer. UPMC policy prohibits discrimination or harassment on the basis of race, color, religion, ancestry, national origin, age, sex, genetics, sexual orientation, gender identity, marital status, familial status, disability, veteran status, or any other legally protected group status. Further, UPMC will continue to support and promote equal employment opportunity, human dignity, and racial, ethnic, and cultural diversity. This policy applies to admissions, employment, and access to and treatment in UPMC programs and activities. This commitment is made by UPMC in accordance with federal, state, and/or local laws and regulations.
Medical information made available on UPMC.com is not intended to be used as a substitute for professional medical advice, diagnosis, or treatment. You should not rely entirely on this information for your health care needs. Ask your own doctor or health care provider any specific medical questions that you have. Further, UPMC.com is not a tool to be used in the case of an emergency. If an emergency arises, you should seek appropriate emergency medical services.
For UPMC Mercy Patients: As a Catholic hospital, UPMC Mercy abides by the Ethical and Religious Directives for Catholic Health Care Services, as determined by the United States Conference of Catholic Bishops. As such, UPMC Mercy neither endorses nor provides medical practices and/or procedures that contradict the moral teachings of the Roman Catholic Church.
Pittsburgh, PA, USA UPMC.com