Potential epidural anesthesia risk of spinal dural arteriovenous fistula diagnosed and evaluated by indocyanine green fluorescence

A patient was admitted to our hospital and scheduled to receive left knee arthroplasty and right knee arthroscopic debridement under epidural anesthesia. After anesthesia and surgery, the patient developed below T12 sensory perception lost, urinary retention and fecal incontinence. Magnetic resonance examination was conducted. Spinal hematoma, injury and other epidural anesthesia related complications were excluded. Spinal dural arteriovenous fistula (SDAVF) was diagnosed and removed under indocyanine green staining. Indocyanine green staining is a simple and accurate method for the differential diagnosis of spinal dural arteriovenous fistula with spinal complications. It can also be used to judge the accurate location of arteriovenous fistula and evaluate the effect of arteriovenous fistula resection.