Spinal dural arteriovenous fistula (dAVF) is an extremely rare vascular entity that is usually misdiagnosed. We sought to determine the long-term clinical outcomes of patients undergoing microsurgical treatment for delayed diagnosis of spinal dAVF. This retrospective study identified patients with delayed diagnosed spinal dAVF at our institution from 2009 to 2018. Patients’ data, including demographics, imaging, and follow-up data, were evaluated. This cohort included 65 consecutive patients with 68 dAVFs and a male-to-female ratio of 4:1 and a mean age of 53.5 ± 13.7 years. The presenting symptoms consisted of limb weakness (n = 42, 64.6%), paraparesis (n = 34, 52.3%), sphincter disturbances (n = 8, 12.3%), and pain (n = 13, 20.0%). The proportion of patients with each symptom significantly increased and patients experienced increased disability when the diagnosis was finalized. The mean length of delay of diagnosis was 20.7 ± 30.0 months. Surgery resulted in complete occlusion of the fistula on the first attempt in all patients. Three patients developed recurrent fistulas, and three died in the follow-up period. Improved motor function was achieved in 38 patients (59.5%). Other symptoms, such as sensory disorders, sphincter dysfunction, and pain, improved by 37.3%, 32.3%, and 66.7%, respectively. Patients with spinal dAVF usually exhibit progressive ascending myelopathy and often remain misdiagnosed for months to years. Some patients’ increased disability cannot be reversed through surgery.

脊髓硬脑膜动静脉瘘（dAVF）是一种极为罕见的血管实体，通常会被误诊。我们试图确定接受显微外科治疗延迟诊断脊柱dAVF的患者的长期临床结局。这项回顾性研究确定了我们机构从2009年至2018年诊断为dAVF延迟的患者。评估了患者的数据，包括人口统计学，影像学和随访数据。该队列包括65位连续的68 dAVF患者，男女比例为4：1，平均年龄为53.5±13.7岁。出现的症状包括肢体无力（n = 42，64.6％），轻瘫（n = 34，52.3％），括约肌干扰（n = 8，12.3％）和疼痛（n = 13，20.0％）。最终确定诊断时，每种症状的患者比例显着增加，并且残疾程度增加。诊断的平均延迟时间为20.7±30.0个月。手术导致所有患者首次尝试瘘管完全闭塞。三名患者发展为复发性瘘管，三名在随访期间死亡。38例患者（59.5％）的运动功能得到改善。其他症状，如感觉障碍，括约肌功能障碍和疼痛，分别改善了37.3％，32.3％和66.7％。脊柱dAVF患者通常表现出进行性上升性脊髓病，并经常被误诊数月至数年。有些患者的残疾增加无法通过手术逆转。0个月。手术导致所有患者首次尝试瘘管完全闭塞。三名患者发展为复发性瘘管，三名在随访期间死亡。38例患者（59.5％）的运动功能得到改善。其他症状，如感觉障碍，括约肌功能障碍和疼痛，分别改善了37.3％，32.3％和66.7％。脊柱dAVF患者通常表现出进行性上升性脊髓病，并经常被误诊数月至数年。有些患者的残疾增加无法通过手术逆转。0个月。手术导致所有患者首次尝试瘘管完全闭塞。三名患者发展为复发性瘘管，三名在随访期间死亡。38例患者（59.5％）的运动功能得到改善。其他症状，如感觉障碍，括约肌功能障碍和疼痛，分别改善了37.3％，32.3％和66.7％。脊柱dAVF患者通常表现出进行性上升性脊髓病，并经常被误诊数月至数年。有些患者的残疾增加无法通过手术逆转。例如感觉障碍，括约肌功能障碍和疼痛，分别改善了37.3％，32.3％和66.7％。脊柱dAVF患者通常表现出进行性上升性脊髓病，并经常被误诊数月至数年。有些患者的残疾增加无法通过手术逆转。例如感觉障碍，括约肌功能障碍和疼痛，分别改善了37.3％，32.3％和66.7％。脊柱dAVF患者通常表现出进行性上升性脊髓病，并经常被误诊数月至数年。有些患者的残疾增加无法通过手术逆转。