Pediatric Dilemma: Endovascular versus Surgical Intervention for Spinal Vascular Malformations

Abstract

Objective: Spinal arteriovenous malformations (AVM) manifest in the pediatric population very differently from the ones in adulthood. Despite that fact, the treatment strategy is quite the same, which provokes a question – whether some of the therapies have an advantage and if so, in which age group. Methods: For this reason, the authors searched the world literature between 1989 and 2018 for spinal AVM in children and further categorized the studies into two age groups: < 12 and ≥12. Results: The total number of included studies in this meta-analysis is 35. Seventeen of them are on the subject of AVM and 15 on the subject of arteriovenous fistula. Three studies encompass both types of lesions. Conclusion: After processing the data, we observed that there is no relationship between age group and the utilized management, except for the endovascular AVF in children less than 12 years of age. Because of this, it should be strongly considered in further management planning.