J Breslau1, J M Eskridge. 1. Department of Radiology, University of Washington School of Medicine, Seattle, USA.
Abstract
PURPOSE: The authors retrospectively reviewed their 6-year clinical experience with preoperative embolization of hypervascular tumors of the spine. PATIENTS AND METHODS: Fourteen patients ranging in age from 16 to 70 years underwent a total of 17 embolization procedures (one patient underwent four procedures) with polyvinyl alcohol particles. The lesions were located from the lower cervical to upper lumbar spine. The primary symptom at patient presentation was back pain, although several patients had lower extremity weakness. Seven of 14 patients had metastatic lesions from renal cell carcinoma. The remaining seven had a variety of hypervascular lesions. RESULTS: Embolization was technically successful in all patients. No complications were attributable to the angiography or embolization procedures. Median estimated blood loss during surgical resection was 1.6 L. In one patient, embolization resulted in relief of back pain, allowing surgery to be postponed for 1 month. In two patients, embolization was performed after previous surgery that was unsuccessful due to excessive blood loss. These vertebral lesions were subsequently removed without complication. CONCLUSIONS: Embolization of vertebral metastases is a safe treatment prior to surgical resection. With appropriate monitoring, complications can be eliminated. The resulting devascularization allows for an aggressive resection of pathologic tissue.
PURPOSE: The authors retrospectively reviewed their 6-year clinical experience with preoperative embolization of hypervascular tumors of the spine. PATIENTS AND METHODS: Fourteen patients ranging in age from 16 to 70 years underwent a total of 17 embolization procedures (one patient underwent four procedures) with polyvinyl alcohol particles. The lesions were located from the lower cervical to upper lumbar spine. The primary symptom at patient presentation was back pain, although several patients had lower extremity weakness. Seven of 14 patients had metastatic lesions from renal cell carcinoma. The remaining seven had a variety of hypervascular lesions. RESULTS: Embolization was technically successful in all patients. No complications were attributable to the angiography or embolization procedures. Median estimated blood loss during surgical resection was 1.6 L. In one patient, embolization resulted in relief of back pain, allowing surgery to be postponed for 1 month. In two patients, embolization was performed after previous surgery that was unsuccessful due to excessive blood loss. These vertebral lesions were subsequently removed without complication. CONCLUSIONS: Embolization of vertebral metastases is a safe treatment prior to surgical resection. With appropriate monitoring, complications can be eliminated. The resulting devascularization allows for an aggressive resection of pathologic tissue.
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