Vascular Abnormalities and Malformations of the Spine

Vascular abnormalities and malformations occur when atypical growths or connections between arteries and veins interfere with blood flow within the spinal canal.

WakeMed’s neurosurgeons and neurologists work in collaboration with cardiologists, vascular surgeons, nurses, neuroradiologists and rehabilitation specialists to develop a personalized treatment plan for corrective approaches to these painful and, at times, debilitating conditions.

Symptoms of Vascular Abnormalities and Malformations

Some people have no symptoms, but others may experience any of the following:

• Headache
• Numbness, tingling, burning, electrical shock-life feeling and/or pain
• Weakness on one or both sides of the body
• Difficulty walking, climbing stairs, balancing and/or coordinating movements
• Dizziness
• Sensitivity to light

Types and Causes of Vascular Abnormalities and Malformations

Vascular abnormalities may develop during or after pregnancy as well as from other trauma, tumors, infection, autoimmune disorders, congenital conditions and more. There are three types:

• Spinal arterial aneurysms are typically small and difficult to spot. Often, they heal without intervention, but if they rebleed, outcomes can be severe.
• Spinal lesions cause injury, alteration or destruction of the nerve tissue in the spine.
• Neoplastic tumors have no known causes, unlike spinal arterial aneurysms and spinal lesions. Three main types of neoplastic tumors include extradural, intradural, and intradural-intramedullary tumors. They are classified by location in and around the vertebral column or the spinal cord.

Of the three types of vascular malformations, the causes are unknown.

• Spinal arteriovenous malformations cause arteries and veins to rupture and spill blood inside the spinal cord.
• Arteriovenous fistulas clog veins, reducing the stream of oxygen-rich blood to other parts of the body, leading to swelling in your spinal cord.
• Cavernous malformations leak blood into the spine from overly full blood vessels.

Diagnosing Vascular Abnormalities and Malformations

Imaging tests, including X-ray, computed tomography (CT) scan, spinal angiogram and magnetic resonance imaging (MRI), may be taken. These tests help us visualize the internal structures in the back, including nerves, spinal cord, bones and soft tissues. You may also be given contrast dye to help the spinal canal show up better in the pictures, so alert your doctor if you’re allergic to contrast dye.

Treating Vascular Abnormalities and Malformations

Abnormalities require medical intervention, and treatment varies based on the cause of the abnormality.

• Surgical correction, drainage or removal are typical.
• Radiation, chemotherapy or targeted therapies may be used on malignant tumors.
• If infection is the cause, treatment may focus first on underlying conditions.
• Physical therapy may be employed after any of the above procedures to help restore full function. We offer comprehensive physical therapy services in many convenient locations. Learn more about our rehab and physical therapy services.

Vascular malformations must be treated by a doctor. Three treatment options are typically considered.

• Radiation therapy may be used to shrink a malformation.
• Endovascular embolization allows doctors to thread a tiny tube into the blood vessel to seal it off.
• Surgery may be the best option for patients whose vascular malformation is already damaging the spinal cord, bleeding or causing severe debilitation:
• Stiff neck
• Loss of bladder or bowel control
• Lack of feeling and/or partial paralysis in the buttocks, inner thighs or legs
• Erectile dysfunction (in men) o Seizures

Make an Appointment

We welcome new patients. If you’d like to meet with one of WakeMed’s neurological experts, please make an appointment by calling us at 919-350-7000.