ABSTRACT NUMBER: ESOC2026A181 IMPACT OF DIAGNOSTIC DELAY ON DISABILITY AND EARLY POST TREATMENT RECOVERY IN SPINAL DURAL ARTERIOVENOUS FISTULAS: A THREE-YEAR ENDOVASCULAR COHORT STUDY

Abstract Background and aims Spinal dural arteriovenous fistulas (sDAVF) are the most common intradural spinal vascular malformations, yet they remain frequently underdiagnosed. Incidious clinical onset and misinterpretation of initial MRI can lead to delayed recognition and progressive venous hypertensive myelopathy. Using statistical techniques, this research analyzes the clinical features, diagnostic delay, and short-term outcomes following endovascular therapy to investigate disability predictors. Methods A retrospective observational study including 9 patients diagnosed with sDAVF from 2022–2025. All patients underwent complete spinal MRI and selective spinal angiography. Functional status was assessed using the Aminoff–Logue (AL) gait and sphincter scores and the modified Rankin Scale (mRS). Associations between diagnostic delay and disability scores were explored with Pearson or Spearman correlation, as appropriate. A simple linear regression model evaluated diagnostic delay as a predictor of AL scores (β-coefficient, 95% CI, p-value). Statistical significance was set at p<0. 05, outcomes before and after treatment compared using paired t-tests. Results Mean age was 54.5 years; 7/9 were male. Median diagnostic delay was 7.11 months. Common comorbidities included degenerative spine disease (56.4%), hypertension (35.6%), and type 2 diabetes (23.4%). Post-treatment analysis demonstrated significant improvement in AL gait and sphincter scores (Wilcoxon p<0.05). Linear regression showed a positive β-trend between longer diagnostic delay and worse baseline AL scores, although not statistically significant (p>0.05), likely due to the small sample size. Conclusions Diagnostic delays in sDAVF remain common and correlate with greater neurological disability. Endovascular treatment achieved marked functional improvement. Incorporating structured MRI protocols and multidisciplinary evaluation is essential to reduce delays and improve outcomes. Conflict of interest Oneda Çibuku: Nothing to disclose Figure 1 - belongs to Results