Spinal intraosseous arteriovenous malformation as a cause of juvenile scoliosis. A case report.

STUDY DESIGN: A case report.

OBJECTIVES: To report and discuss an unusual case of scoliosis resulting from an arterial malformation of the spine.

SUMMARY OF BACKGROUND DATA: This is a report of clinical manifestation, physical findings, computed tomography scan, magnetic resonance imaging, bone scan, and results after surgery in an 8-year-old boy with a painful scoliosis resulting from an intraosseous arteriovenous malformation of the spine.

METHODS: Radiographs, computed tomography scan, magnetic resonance imaging, and bone scans were studied and oriented us to the diagnosis of scoliotic attitude secondary to a benign-appearing tumor in the right lamina of L4. Surgery was performed through a posterior midline approach to remove the lesion en bloc. Postoperative treatment was performed with a Boston orthosis.

RESULTS: Final pathology reports diagnosed an intraosseous arteriovenous malformation. After 32 months, the boy had no pain, and scoliotic attitude diminished despite radiographs still showing a single 10 degrees right lumbar curve.

CONCLUSIONS: Primary intraosseous arteriovenous malformations are rare. This case shows the scarce specificity of clinical findings, radiology, and bone scan in the diagnosis of these lesions when they are localized in vertebral territory. Surgical excision of the lesion relieves pain but does not completely correct the scoliotic attitude.