{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T01:19:50Z","timestamp":1787707190090,"version":"build-2784847793"},"reference-count":14,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"8","license":[{"start":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T00:00:00Z","timestamp":1787529600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurosurg Case Lessons"],"published-print":{"date-parts":[[2026,8,24]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Sacral extradural arteriovenous fistula (AVF) associated with filum terminale (FT) is an extremely rare disease. Here, the authors report a progressive congestive myelopathy accompanied by tethered cord syndrome and lipoma.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>A 52-year-old woman who had a subcutaneous mass in the sacrococcygeal region since birth and developed urinary dysfunction 5 years earlier and gait disturbance 3 years earlier was referred for progressive paraplegia. She presented with myelopathy below the T11 level, and spinal MRI revealed edema with intramedullary hyperintensity changes, surrounding flow voids, and retain medullary cord with sacral lipoma. Spinal angiography revealed reflux from the left lateral sacral artery through the AVF within the lipoma to the vein of the FT within the dura mater. Preoperatively, the patient experienced worsening neurological symptoms, and endovascular embolization was followed by surgical curative treatment. Postoperatively, improvement in symptoms was observed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>In sacral AVF associated with FT, knowledge of vascular anatomy and classification diagnosis significantly influence the treatment outcome.<\/jats:p>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/thejns.org\/doi\/10.3171\/CASE26546\">https:\/\/thejns.org\/doi\/10.3171\/CASE26546<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case26546","type":"journal-article","created":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T00:01:16Z","timestamp":1787097676000},"source":"Crossref","is-referenced-by-count":0,"title":["Sacral extradural arteriovenous fistula in a filum terminale lipoma with retained medullary cord: illustrative case"],"prefix":"10.3171","volume":"12","author":[{"given":"Hisaaki","family":"Uchikado","sequence":"first","affiliation":[{"name":"Uchikado NeuroSpine Clinic, Hakata, Fukuoka"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takayasu","family":"Ando","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Saiseikai Fukuoka General Hospital, Fukuoka"},{"name":"Department of Neurosurgery, Kurume University, Kurume"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuko","family":"Baba","sequence":"additional","affiliation":[{"name":"Baba Hospital EndoSpine Center, Hirokawa, Fukuoka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-2433-2176","authenticated-orcid":true,"given":"Takehiro","family":"Makizono","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Kurume University, Kurume"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gohsuke","family":"Hattori","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Kurume University, Kurume"},{"name":"Baba Hospital EndoSpine Center, Hirokawa, Fukuoka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2019-1732","authenticated-orcid":true,"given":"Kiyohiko","family":"Sakata","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Kurume University, Kurume"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"3","key":"bib1","series-title":"Asian Spine J","first-page":"365","article-title":"Arteriovenous fistula of the filum terminale misdiagnosed and previously operated as lower lumbar degenerative disease","volume":"8","author":"Sharma","year":"2014","unstructured":"Sharma PRanjan ALath R.Arteriovenous fistula of the filum terminale misdiagnosed and previously operated as lower lumbar degenerative disease. Asian Spine J. 2014;8(3):365-370. doi:10.4184\/asj.2014.8.3.365"},{"issue":"10","key":"bib2","series-title":"AJNR Am J Neuroradiol","first-page":"1846","article-title":"Spinal arteriovenous fistulas of the filum terminale","volume":"32","author":"Lim","year":"2011","unstructured":"Lim SMChoi ISDavid CA.Spinal arteriovenous fistulas of the filum terminale. AJNR Am J Neuroradiol. 2011;32(10):1846-1850. doi:10.3174\/ajnr.A2612"},{"issue":"10","key":"bib3","series-title":"J Neurosurg Case Lessons","first-page":"CASE25864","article-title":"Foix-Alajouanine syndrome caused by MRI occult thoracic ventral perimedullary arteriovenous fistula: illustrative case","volume":"11","author":"Ohkubo","year":"2026","unstructured":"Ohkubo TUchikado HTakashima CFoix-Alajouanine syndrome caused by MRI occult thoracic ventral perimedullary arteriovenous fistula: illustrative case. J Neurosurg Case Lessons. 2026;11(10):CASE25864. doi:10.3171\/CASE25864"},{"issue":"2","key":"bib4","series-title":"Neurointervention","first-page":"93","article-title":"Reversible symptom aggravation by intake of taurine-rich foods in patients with venous congestive myelopathy: controlled case series study","volume":"17","author":"Suh","year":"2022","unstructured":"Suh DCJeong SChoi YHReversible symptom aggravation by intake of taurine-rich foods in patients with venous congestive myelopathy: controlled case series study. Neurointervention. 2022;17(2):93-99. doi:10.5469\/neuroint.2022.00129"},{"issue":"1","key":"bib5","series-title":"Brain","first-page":"211","article-title":"The prognosis of patients with spinal vascular malformations","volume":"97","author":"Aminoff","year":"1974","unstructured":"Aminoff MJLogue V.The prognosis of patients with spinal vascular malformations. Brain. 1974;97(1):211-218. doi:10.1093\/brain\/97.1.211"},{"issue":"2","key":"bib6","series-title":"J Neurosurg Spine","first-page":"149","article-title":"The filum terminale externum","volume":"3","author":"Tubbs","year":"2005","unstructured":"Tubbs RSMurphy RLKelly DRLott RSalter EGOakes WJ.The filum terminale externum. J Neurosurg Spine. 2005;3(2):149-152. doi:10.3171\/spi.2005.3.2.0149"},{"issue":"6","key":"bib7","series-title":"Neurol Med Chir (Tokyo)","first-page":"310","article-title":"Vascular anatomy of the cauda equina and its implication on the vascular lesions in the caudal spinal structure","volume":"56","author":"Namba","year":"2016","unstructured":"Namba K.Vascular anatomy of the cauda equina and its implication on the vascular lesions in the caudal spinal structure. 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Surg Neurol Int. 2022;13(13:78):78. doi:10.25259\/SNI_980_2021"},{"key":"bib9","series-title":"World Neurosurg","first-page":"231","article-title":"Filum terminale arteriovenous fistula in association with degenerative lumbosacral spinal canal stenosis: report of 3 cases and review of the literature","volume":"138","author":"Iampreechakul","year":"2020","unstructured":"Iampreechakul PTirakotai WWangtanaphat KLertbutsayanukul PSiriwimonmas S.Filum terminale arteriovenous fistula in association with degenerative lumbosacral spinal canal stenosis: report of 3 cases and review of the literature. 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Interv Neuroradiol. 2021;27(3):451-455. doi:10.1177\/1591019920968363"},{"issue":"1","key":"bib11","series-title":"J Neurointerv Surg","first-page":"292","article-title":"Updated classification with spinal dysraphism and treatment outcomes of arteriovenous shunts below conus: a retrospective cohort study","volume":"18","author":"Fan","year":"2025","unstructured":"Fan YXYang CBLi JWUpdated classification with spinal dysraphism and treatment outcomes of arteriovenous shunts below conus: a retrospective cohort study. J Neurointerv Surg. 2025;18(1):292-298. doi:10.1136\/jnis-2024-022574"},{"issue":"3","key":"bib12","series-title":"Neuroradiol J","first-page":"251","article-title":"Treatment of filum terminale pial arteriovenous fistulas in the sacral region: a case report and systematic review","volume":"36","author":"Guo","year":"2023","unstructured":"Guo YYu J.Treatment of filum terminale pial arteriovenous fistulas in the sacral region: a case report and systematic review. 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World Neurosurg. 2020;140:37-45. doi:10.1016\/j.wneu.2020.04.239"}],"container-title":["Journal of Neurosurgery: Case Lessons"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-case-lessons\/12\/8\/article-CASE26546.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-case-lessons\/12\/8\/article-CASE26546.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-case-lessons\/12\/8\/article-CASE26546.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T00:38:23Z","timestamp":1787704703000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-case-lessons\/12\/8\/article-CASE26546.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,24]]},"references-count":14,"journal-issue":{"issue":"8"},"URL":"https:\/\/doi.org\/10.3171\/case26546","relation":{},"ISSN":["2694-1902"],"issn-type":[{"value":"2694-1902","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,24]]}}}