The objective of this retrospective study is to more fully understand the optimal strategy to manage spinal arteriovenous (AV) shunts. This study included a cohort of 35 patients with a diagnosis of spinal AV shunts who were treated over the past 10 years at a single institute. Angiographic diagnosis of intramedullary AV malformations (IM-AVM), perimedullary AV fistulas (PM-AVF), dural AV fistulas (D-AVF), or epidural AV fistulas (ED-AVF) was carefully made, and the microsurgical or endovascular strategy for them was determined at the interdisciplinary meeting consisting of neurospinal surgeons and endovascular specialists. Endovascular surgery was first considered whenever safely possible. Microscopic direct surgery using intraoperative image guidance was considered for cases in which endovascular access was challenging or not safely possible. Combined treatment was another option. The clinical condition was assessed using the modified Rankin scale (mRS). Seventeen of 35 cases were treated with microscopic direct surgery, 13 cases with endovascular surgery, and the remaining five cases with the combination. Complete angiographic obliteration was achieved in 30 of 35 cases (85.7%). Although residual AV shunts was recognized in 3 cases of IM-AVM, 1 case of PM-AVF and 1 case of ED-AVF, no angiographic recurrence was present with an average postoperative follow-up period of 44 months. The average mRS before surgery was 2.37 and significantly improved to 1.94 at the most recent follow-up. Interdisciplinary collaboration between neurospinal surgeons and endovascular specialists should be standard to achieve safe and successful outcomes in treating such rare and difficult spinal disorders.

这项回顾性研究的目的是更全面地了解管理脊髓动静脉（AV）分流器的最佳策略。这项研究纳入了35名诊断为脊髓性AV分流的患者，这些患者在过去的10年中在一家机构接受过治疗。仔细进行了髓内AV畸形（IM-AVM），髓周AV瘘（PM-AVF），硬脑膜AV瘘（D-AVF）或硬膜外AV瘘（ED-AVF）的血管造影诊断，并采用了显微外科手术或血管内策略他们是在神经脊髓外科医生和血管内专家组成的跨学科会议上确定的。首先应尽可能安全地考虑进行血管内手术。对于血管内通路具有挑战性或无法安全进行的情况，考虑使用术中图像引导进行显微直接手术。联合治疗是另一种选择。使用改良的兰金量表（mRS）评估临床状况。35例中有17例接受了显微直接手术，13例接受了血管内手术，其余5例接受了联合手术。35例中有30例完全闭塞了血管造影术（85.7％）。尽管在3例IM-AVM，1例PM-AVF和1例ED-AVF中发现了残留的AV分流，但没有血管造影复发，平均术后随访时间为44个月。手术前的平均mRS为2.37，在最近的随访中显着提高至1.94。神经脊外科医生和血管内专家之间的跨学科合作应该成为治疗这种罕见和困难的脊柱疾病的安全和成功结果的标准。