Thoracic Epidural Arteriovenous Malformation Disease, or TEAM Disease, are the most common spinal vascular malformations. Most are thoracolumbar, posterior, and outside the cord (extramedullary). The rest are cervical or upper thoracic and often inside the cord (intramedullary). AVMs may be small and localized or may affect up to half the cord. They may compress or even replace normal spinal cord parenchyma, or they may rupture, causing focal or generalized hemorrhage.

They are tangles of abnormal blood vessels that directly connect arteries and veins. Symptoms include weakness or numbness of the arms or legs, or bowel/bladder disturbance. These symptoms may be caused by elevated venous pressure within the spinal cord, mass effect from the AVM, or hemorrhage.

Symptoms

Sometimes benign tumors overlies thoracic epidural arteriovenous malformation disease.

  • Nerve roots, causing pain that radiates down the distribution of a nerve root (radicular pain)
  • The spinal cord, causing segmental neurologic deficits that gradually progress or that wax and wane

Combined lower and upper motor neuron deficits are common. TEAM may rupture into the spinal cord parenchyma, causing sudden, severe back pain and sudden segmental neurologic deficits. Rarely, high cervical AVMs rupture into the subarachnoid space, causing sudden and severe headache, nuchal rigidity, and impaired consciousness.

Diagnosis

TEAM disease may be detected incidentally during imaging.This disease is suspected clinically in patients with unexplained segmental neurologic deficits or subarachnoid hemorrhage, particularly those who have sudden, severe back pain or cutaneous abnormal growth produced by the dilatation or new formation of blood vessels.

  • Magnetic resonance imaging (MRI) – used to show detailed images of nerve damage or tumors that cannot be seen on an x-ray.
  • Spinal angiogram
  • Myelography
  • Computerized Tomography (CT) scan – used to create the spine’s three-dimensional (3D) image
Treatment

Surgical treatment may be necessary if spinal cord function is threatened or compromised. Burak Ozgur, MD has the expertise in minimally invasive spine surgery and microtechniques to be able to treat TEAM disease. Treatment of TEAM disease is focused on preventing further progression. Stereotactic radiosurgery is helpful if the TEAM disease is small and located in a surgically inaccessible location. Angiographic embolization often precedes surgical removal or stereotactic radiosurgery.

Burak Ozgur, MD treats thoracic epidural arteriovenous malformation disease or TEAM disease. Learn more about our minimally invasive procedures or request an appointment for consultation by calling (949) 383-4190 or toll free 888-64-SPINE or Contact Us ➲.