Analysis of the treatment pathway and causes of delay in a young patient with spinal arteriovenous malformations: A case report

• SAVMs is a rare vascular disease, with a high misdiagnosis rate among young people. • The case reports the whole process from the discovery of the symptoms to the acceptance of the correct treatment. • At last, The young man had endovascular embolization (DS+ EMB) at a tertiary hospital. • This study analyzes the reasons for delayed diagnosis and proposes suggestions for improvement. Spinal arteriovenous malformations (SAVMs) are rare, Early insidious, non-specific symptoms cause diagnostic delay—higher in adolescents—leading to psychological distress, educational interruption, poor prognosis, and more. Timely intervention improves outcomes, but research on young patients’ pre-admission clinical trajectory is limited. A 20-year-old male with 1-month lower limb weakness/numbness and sphincter disturbance was diagnosed with SAVMs. Initial low back pain was ignored due to his intense training but symptoms progressed to urinary/defecatory dysfunction. Spinal CT was normal, MRI showed T9-L3 abnormal signals and T8-T12 spinal cord edema. Even with worsening symptoms every day the time from the discovery of the symptoms to the acceptance of the correct treatment was 40 days. The young man had endovascular embolization (DSA + EMB) at a tertiary hospital. Access to the right common femoral artery was gained via the Seldinger method, delivering embolic agents(N-butyl cyanoacrylate NBCA) into this vessel, control angiography confirmed a significant reduction in both blood flow velocity and volume within the malformed vasculature. Post-rehabilitation, 3-month follow-up showed normal walking, recovered defecation, Urinary Functionand improved neurological function (Aminoff & Logue Scale changed from 7to 0. Diagnostic delays stem from atypical symptoms, primary physicians’ limited experience, and poor early screening. Strategies like physician training, optimized diagnostics, and public education are recommended to improve timely SAVM care.