Introduction:
Aneurysms of the spinal arteries are rare entities, the majority of which are associated with other vascular lesions, such as spinal vascular malformations. Isolated spinal artery aneurysms (SAA) are even less frequently encountered, and their incidence is largely unknown, as the literature is limited to case reports and small series. The optimal management strategy for SAAs is not well defined. This presentation will review our institutional experience with the management of isolated SAAs and the literature on treatment options.
Methods:
Cases of isolated SAAs treated at our center within the last 5 years were identified, and the clinical presentation, management, and outcome were reviewed. A literature review was performed using the search terms: “spinal aneurysm,” “spinal artery aneurysm,” “radicular artery aneurysm.”
Results:
Three cases of isolated SAAs were identified, including one case with multiple simultaneous SAAs. Clinical presentation included back pain and neurological deficit in all cases, in the setting of hemorrhage. A 23-year-old male with paraplegia and a left T7 dissecting radicular SAA was treated with initial glue embolization and subsequent evacuation of significant subdural hematoma with eventual recovery to ambulatory status. A 72-year-old female with a dissecting T12 radicular SAA underwent surgical trapping and hematoma evacuation, with significant gradual recovery of neurological function. A 60-year-old female with multiple dissecting SAAs at T3, T6, and T10 radicular arteries was managed conservatively, and repeat angiogram demonstrated complete spontaneous regression of all three SAAs. Literature review revealed treatment strategies including conservative management, glue or coil embolization, muslin wrapping, and surgical resection or clipping.
Conclusions:
Multiple management strategies exist for SAAs, and clinical consideration of patient presentation and lesion morphology determine appropriate strategy. Our case series demonstrates three of these treatment paradigms, all with good or fair neurological outcome.
Patient Care:
This review will provide insight into the treatment paradigm for isolated spinal artery aneurysms.
Learning Objectives:
This poster presentation will provide a detailed description of three illustrative cases of isolated spinal artery aneurysms and their management, as well as a literature review of treatment options.