AVM means a wrong connection between the arteries and veins and leads to swelling of blood vessels and there is always a danger of bleeding in these abnormal blood vessels.
What is Spinal AVM? Spinal Cord arteriovenous malformation (SCAVM) is a relatively rare disease. Normally the oxygen rich blood enters the spinal cord through arteries which further branch into smaller blood capillaries and the oxygen is utilized. Veins carry the oxygen depleted blood away from spinal cord to other parts of the body. When the blood directly passes from the arteries to the veins, bypassing the capillaries, the condition is known as spinal AVM. This disturbance of flow in blood deprives the surrounding cells of vital oxygen and causes cells in your spinal tissue to rapture, deteriorate, bleeding in spinal cord or die. Timely diagnosis and treatment can prevent the spinal cord from permanent damage.
The process being completely pain free and 100% safe (with no side effects), also eliminates the use of anesthesia or other invasive head frames for stabilizing (as in case of other traditional techniques like gamma knife). Almost in 99% of the cases patients recover within single treatment and get back to normal activity immediately after the procedure.
Spinal AVM – though rare, more common in children: Spinal AVMs can occur at any age, but more than 80% present between age 20 and 60 years. More rarely younger persons may present due to this rare lesions.
What are the symptoms? If left unnoticed the condition only worsens over time with elevated back pain, sensory loss and weakening of leg muscles. The patient may feel numbness, weakness, loss of bowel control. Depending on the severity and location the symptoms may vary. Random pain throughout the body and burning sensations are usually the marked symptoms. It is thus advised to immediately consult a neurosurgeon in case the symptoms persist, as delay in diagnosis may lead to worsen the complications.
How it is treated? High-resolution MRI is very useful in diagnosis of presence of spinal AVM. Thereafter the lesion is study in detail by spinal angiography. In this procedure, a small tube (catheter) is sent through leg blood vessel and injection is done in spinal arteries to detect the location of abnormal connection between artery and vein .
Embolization is a preferred and minimally invasive technique for treating AVM with surgery. But sometimes due to its complex location and size, the surgery may require high expertise and skills, where a new and advanced procedure is useful.
Cyberknife radiation surgery reduces the long term risks of AVM hemorrhage by delivering high doses of radiation to shrink it completely. With the use of latest image guidance and computer assisted robotic system, the procedure delivers multiple beams of high frequency radiation to the actual site from all the directions. Another advantage is that the missile guided technology can also automatically track and detect any movement in patient to correct the delivery of radiation beams to the exact treatment location. During the procedure, the robotic arm slowly moves around the patient and they will not feel anything. The patients can be as relaxed as always in their own dresscomfortably listening to music. The process being completely pain free and 100% safe (with no side effects), also eliminates the use of anesthesia or other invasive head frames for stabilizing (as in case of other traditional techniques like gamma knife). Almost in 99% of the cases patients recover within single treatment and get back to normal activity immediately after the procedure.
(The author is Director-Neurosurgery & Head Cyberknife, Artemis Hospital. Views are his own)
