Spinal Vascular Disorders
Spinal Vascular Disorders: At a Glance
What it is: Spinal vascular disorders are rare conditions where abnormal blood vessels form in or around the spinal cord, disrupting normal blood flow.
How it affects people: They may cause back pain, weakness, numbness, bladder/bowel problems, or even paralysis if left untreated.
Key concern: Progressive spinal cord damage from reduced oxygen supply or bleeding into the spinal canal.
Diagnosis: Usually confirmed with magnetic resonance imaging (MRI), spinal angiography, or other specialist imaging tests.
Treatment options: Observation, microsurgery, endovascular embolization, or a combination of approaches depending on the type of disorder.
Outlook: With early detection and tailored treatment, many patients regain function and prevent long-term neurological deficits.
What are Spinal Vascular Disorders?
Spinal vascular disorders occur when blood vessels around the spinal cord develop abnormal connections or malformations, altering blood flow. This can increase pressure, cause bleeding in the spinal canal, or reduce oxygen supply to spinal tissues.
Although rare, these disorders can lead to significant symptoms. Prompt recognition and treatment are essential to preserve neurological function.
Spinal vascular disorders can affect the blood vessels of the spinal cord itself or the surrounding spinal column. The main types include:
Dural arteriovenous fistula (dAVF): A type of vascular malformation of the spinal cord where arteries connect abnormally to veins in the dura mater. This is the most common acquired spinal vascular disorder in adults.
Types of Spinal Vascular Disorders
Intramedullary arteriovenous malformations (AVMs): Abnormal tangles of arteries and veins within the spinal cord (sometimes called “glomus AVMs”). These may rupture or cause progressive neurological symptoms.
Other spinal vascular malformations: Specialists also recognise rarer types such as juvenile AVMs and perimedullary AVFs.
Cavernous malformations: Clusters of thin-walled vessels prone to leakage and small bleeds.
Spinal hemangiomas: Benign vascular tumours within vertebrae, sometimes causing compression or pain.
Other rare lesions: Such as venous malformations or capillary telangiectasias, which are less common but can still affect spinal function.
Specialists may further classify conditions by their location, or based on the arteries and veins involved. These disorders vary widely in severity, from small, incidental findings to complex conditions needing intervention.
Spinal Vascular Disorders Symptoms
Spinal vascular disorders symptoms depend on the type and location but may include:
Back pain or neck pain
Progressive weakness in the arms or legs
Numbness or tingling
Difficulty walking or loss of balance
Sudden loss of bladder or bowel control
In severe cases, paralysis
Emergency attention is vital if there are rapid changes in symptoms, as untreated compression can cause permanent damage. Call 999 immediately.
Causes and Who Is at Risk
The exact causes are varied and depend on the type of spinal vascular malformation, but factors can include:
Congenital malformations (present from birth, such as AVMs)
Age-related vascular changes
History of venous thrombosis
Trauma or prior spinal surgery
Associated conditions such as Hereditary Haemorrhagic Telangiectasia (HHT)
Both men and women can develop these disorders, though dural AVFs are more common in middle-aged and older adults.
Getting a Diagnosis
Accurate diagnosis of spinal vascular malformations requires a detailed history, neurological exam, and advanced imaging:
Magnetic resonance imaging (MRI): First-line imaging to show abnormal blood flow and swelling.
Spinal angiography: The gold-standard test to pinpoint the abnormal vessels.
Some cases require CT scans or myelography.
Together, these tests guide a clear diagnosis and treatment plan.
Treatment Options for Spinal Vascular Disorders
Treatment depends on the disorder and severity:
Microsurgery
To disconnect or remove vascular malformations.
Endovascular Embolization
A minimally invasive technique to block abnormal vessels.
Combined Approaches
A tailored combination of techniques to maximise safety and long-term recovery.
Patients are often referred to a neurosurgeon specialising in neurovascular surgery for expert care, such as Mr Kailaya-Vasan.
Living with Spinal Vascular Disorders
Recovery varies depending on the type of vascular malformation and whether spinal cord damage has occurred. With treatment, many patients stabilise or improve, but some may experience residual weakness or sensory changes.
Rehabilitation, physiotherapy, and attention to general health are vital for preserving mobility and improving quality of life.
Even after treatment, regular monitoring and follow-up with your neurovascular specialist are essential to reduce your risk.
Book a consultation with Mr Ahilan Kailaya-Vasan
Receive a clear diagnosis and a tailored treatment plan from a leading consultant neurosurgeon. Appointments are available at top London hospitals, with remote options for international patients.
Seeking a second opinion?
If you have already received a diagnosis elsewhere, Mr Kailaya-Vasan can provide an independent review of your scans and medical notes, and explain the safest and most effective next steps.
FAQs about Spinal Vascular Disorders
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They are rare abnormalities of blood vessels around the spinal cord that disrupt normal blood flow and may damage nerves.
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Symptoms include weakness, numbness, back or neck pain, difficulty walking, or bladder/bowel problems.
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Specialist imaging such as magnetic resonance imaging (MRI) and spinal angiography are essential for accurate diagnosis.
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Options include microsurgery, endovascular embolization, or observation, depending on the type of disorder.
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Yes, they can sometimes be associated with genetic or inherited conditions such as Hereditary Haemorrhagic Telangiectasia (HHT), neurofibromatosis type 1 (NF1), or connective tissue disorders like vascular Ehlers–Danlos syndrome. These conditions can make blood vessels more fragile or prone to forming abnormal connections.
If you have any further questions, please get in touch.