2017 Volume 26 Issue 5 Pages 326-332
The classification of spinal arteriovenous malformations (AVMs) is too complex to understand because of the numerous competing classification systems that have been proposed in the literature over time. Accordingly, English language literature regarding spinal AVMs between 1967 and 2015 were reviewed in order to clarify their historical changes. There were several major landmark papers and corresponding updates in classification : the first description of spinal dural arteriovenous fistulas (AVFs) and intradural AVMs diagnosed by spinal angiography in 1971, the second-generation classification based on the case report of intradural perimedullary AVFs treated by microsurgery in 1986, the third-generation classification based on the case series of intradural perimedullary AVFs treated by endovascular interventions in 1993, the forth-generation classification based on the case series of spinal AVMs treated by microsurgery and endovascular interventions in 2002, and the fifth-generation classification based on the case series of extradural AVFs treated by microsurgery in 2009 and endovascular interventions in 2011. Finally, the development of diagnostic imaging, microsurgery, and endovascular treatment for spinal AVMs have each contributed considerably to the historical changes in their classification system.
