Fig. 2

This 57-year-old female patient with bilateral lower limb weakness is initially referred to the orthopedic department with unsatisfactory results and then referred to neurosurgery for spinal myelography, who is diagnosed with SDAVF. The fistula is located at the level of the right thoracic 10 and thoracic 11 (A, the red triangle is the responsible artery, and the blue is the draining vein). The responsible artery of SDAVF (the red triangle) and the draining veins are seen to be meandering and dilated during the surgery (the blue triangle) (B). The responsible artery and draining veins are confirmed by indocyanine green (ICG) imaging (C). Fluoroscopy is performed to confirm the responsible artery and the draining vein (C). After the responsible artery is clipped with a temporary aneurysm clip, the draining vein does not appear on fluorescence imaging (D). The draining vein reappears after releasing the aneurysm clip (E). The responsible artery is electro-coagulated and cut-off (F, blue arrows). The SDAVF does not appear on postoperative imaging (G, prone position)