Spinal Arteriovenous Malformations (AVMs) are rare but serious vascular disorders in which there is an abnormal tangle of blood vessels (arteries and veins) in or around the spinal cord. These abnormal vessels disrupt normal spinal blood flow and can lead to spinal cord compression, bleeding, progressive weakness, pain, or even paralysis.
Spinal AVM Embolization is a minimally invasive, catheter-based procedure used to close off these abnormal vessels and restore normal blood circulation, prevent hemorrhage, and reduce symptoms. At CARE CHL Hospital, Indore, under the expert guidance of Dr. Alok K. Udiya, this life-altering treatment is performed with extreme precision using advanced neurointerventional techniques and real-time imaging.
Our goal is simple: to preserve spinal cord function and improve quality of life by preventing progression of neurological symptoms.
Key Benefits of the Treatment
Spinal AVM embolization offers a number of critical benefits, including:
- Avoids Open Spine Surgery: No large incision or bone removal is required.
- Controls or Prevents Paralysis: Stops progression of weakness and sensory loss.
- Reduces Risk of Hemorrhage: Especially crucial in patients with history of AVM rupture or spinal bleeding.
- Minimally Invasive: Performed via a small artery puncture using microcatheters.
- Short Recovery Time: Most patients are discharged within 1–2 days post-procedure.
- Improves Surgical Outcomes: In complex cases, embolization is used before surgery to reduce intraoperative bleeding.
- Effective in Multiple AVM Types: Including dural AVFs, perimedullary AVMs, and intradural AVMs.
How This Treatment Works
The procedure is performed in a neuroangiography suite using a biplane DSA system for real-time, high-resolution vessel visualization.
1. Diagnosis and Evaluation
Spinal AVMs can present with:
- Gradual leg weakness or numbness
- Back pain or bladder/bowel dysfunction
- Sudden loss of sensation if bleeding occurs
Imaging studies used include:
- MRI with contrast: Reveals edema or hemorrhage in the spinal cord.
- Spinal DSA (Digital Subtraction Angiography): Gold standard for mapping AVM anatomy.
- CT Angiography or MR Angiography: May aid in pre-procedure planning.
2. Pre-Procedure Preparation
- Patients are evaluated for renal function, allergies, and clotting profile.
- Anticoagulants may be stopped.
- Fasting is advised for 6–8 hours before the procedure.
3. The Embolization Procedure
- A catheter is inserted into the femoral artery and advanced to the spinal arteries (typically intercostal or vertebral arteries).
- A microcatheter is carefully positioned in the feeder vessels of the AVM.
- Under live imaging, liquid embolic agents like Onyx, NBCA glue, or PVA particles are injected to occlude the abnormal shunt.
- If the AVM is complex or has multiple feeders, multiple sessions may be planned.
4. Post-Procedure Monitoring
- Patients are monitored in a neuro ICU for 24 hours.
- Neurological checks are done regularly to assess motor and sensory function.
- MRI or DSA follow-up is performed after a few weeks/months.
- Physiotherapy is started early in symptomatic patients.
Why Choose Dr. Alok K. Udiya at CARE CHL Hospital?
Spinal AVM embolization is among the most technically challenging neurointerventional procedures. It requires expert judgment and precision to avoid harming the spinal cord.
Here’s why Dr. Alok K. Udiya is trusted across Central India:
- Extensive experience in spinal vascular interventions, including rare AVMs and AVFs
- Access to ultra-precise biplane DSA lab for spinal angiography
- Ability to differentiate and manage all types of spinal AVMs
- Collaborates with spinal surgeons and neurologists for hybrid treatments when needed
- High safety record with minimized risk of spinal ischemia or complications
- Offers long-term follow-up and imaging review to ensure AVM control
FAQs – Spinal AVM Embolization
Q1. What causes spinal AVMs?
Most spinal AVMs are congenital, meaning present from birth. However, some dural AVFs may develop later in life due to unknown causes.
Q2. What symptoms do spinal AVMs cause?
Progressive leg weakness, numbness, pain, bladder/bowel issues, or sudden paralysis in case of bleeding. Some AVMs may be asymptomatic until rupture.
Q3. Is embolization curative?
In many cases, yes—especially if the AVM is small and the nidus is accessible. For larger or complex AVMs, it may be part of a staged treatment approach with surgery or radiosurgery.
Q4. Is the procedure painful?
The procedure itself is not painful, as it is done under local anesthesia with sedation or general anesthesia, depending on the case.
Q5. Are there any risks?
Risks include:
- Non-target embolization affecting normal spinal arteries
- Temporary or permanent neurological worsening (rare with expert technique)
- Back pain or inflammation post-embolization
Q6. How long will I stay in the hospital?
Most patients are discharged within 1–2 days unless they have pre-existing neurological deficits requiring rehab.
Q7. What materials are used to block the AVM?
Liquid embolics like Onyx or NBCA glue are commonly used. Coils or particles may be used based on the vessel size and AVM structure.
Q8. How soon will I feel improvement?
Some patients feel immediate relief from pain or weakness. Others improve gradually over weeks to months with physical therapy.
Q9. Will I need repeat procedures?
Possibly, in large or multi-vessel AVMs. Regular follow-up imaging helps monitor recurrence or revascularization.
Q10. Is this procedure covered by insurance?
Yes. Most private and government insurance policies cover embolization for spinal vascular disorders. Our team provides support with approvals.