Although dural arteriovenous fistula (SDAVF) is a rare disease, its incidence is higher than that of spinal angioma. Due to the lack of specificity of clinical manifestations, it is easily confused with spinal stenosis and other spinal osteoarthropathies and intermittent claudication due to lower limb vascular disease, diabetic lumbosacral plexus neuropathy, and spinal cord lesions; early diagnosis is difficult. SDAVF is most commonly seen in elderly men, with common lesions at the level of the lower thoracic and lumbar segments of the spinal cord. The clinical manifestations of SDAVF are progressively aggravated due to impaired blood supply to the spinal cord caused by increased venous pressure; functional impairment is often difficult to recover in long-standing disease. The main manifestations are muscle weakness or even paralysis and atrophy below the affected segment; loss or disappearance of deep and superficial sensation; and impaired bowel movement and urination. Spinal cord magnetic resonance examination shows: 1) abnormal signals in the medulla; 2) vascular flow and emptying on the spinal cord surface, and the diagnosis depends on spinal arteriography. The widely accepted criteria for diagnosis are: age >40 years, especially in men; abnormal sensory, motor and sphincter function in both lower extremities with progressive worsening of symptoms and progressive signs; and abnormal traffic in the dural fistula and arterioles on spinal arteriography. Treatment: surgery as soon as possible after the diagnosis is confirmed.
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