Preoperative spinal tumor embolization: an institutional experience with Onyx.
Publication/Presentation Date
12-1-2013
Abstract
BACKGROUND: Preoperative embolization has the potential to decrease intraoperative blood loss and facilitate spinal cord decompression and tumor resection.
OBJECTIVE: We report our institutional experience with the embolization of hypervascular extradural spinal tumors with Onyx as well as earlier embolic agents in a series of 28 patients.
METHODS: A retrospective case review was conducted on patients undergoing preoperative transarterial embolization of a spinal tumor between 1995 and 2012 at our institution.
RESULTS: Twenty-eight patients met the inclusion criteria, with a mean age of 60.6 years. Twenty-eight patients had metastatic tumors. In 14 (50%) patients the metastases were from renal cell carcinomas. Fifty-four vessels were embolized using PVA, NBCA, Onyx, coils, or embospheres. Sixteen patients were treated with Onyx, 6 patients with PVA, 3 patients with embospheres, 2 patients with NBCA, and 3 patients with a combination of embolic agents. The average decrease in tumor blush was 97.8% with Onyx versus 92.7% with the rest of the embolic agents (p=0.08). The estimated blood loss was 1616ml (range 350-5000ml). Blood loss was 750cm(3) on average with Onyx versus 1844 with the rest of the embolic agents (p=0.14). The mean length of stay was 16 days. The mortality rate was zero. Pre- and post-operative modified Rankin Score (mRS) did not differ significantly in the series (3.12 versus 3.10, respectively, p=0.9).
CONCLUSION: In our experience, the use of transarterial tumor embolization as an adjunct for spinal surgery is a safe and feasible option.
Volume
115
Issue
12
First Page
2457
Last Page
2463
ISSN
1872-6968
Published In/Presented At
Ghobrial, G. M., Chalouhi, N., Harrop, J., Dalyai, R. T., Tjoumakaris, S., Gonzalez, L. F., Hasan, D., Rosenwasser, R. H., & Jabbour, P. (2013). Preoperative spinal tumor embolization: an institutional experience with Onyx. Clinical neurology and neurosurgery, 115(12), 2457–2463. https://doi.org/10.1016/j.clineuro.2013.09.033
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
24169150
Department(s)
Administration and Leadership
Document Type
Article