Preoperative transarterial embolization of spinal tumor: embolization techniques and results.
OBJECTIVE
The techniques of preoperative embolization of hypervascular spinal tumors, which has been known to be helpful for completing tumor resection, have not been described in detail. The purpose of this study was to analyze the technique and to evaluate the safety and value of preoperative transarterial embolization of hypervascular spinal tumors.


METHODS
Eighteen patients with hypervascular spinal tumors underwent transarterial embolization before surgery. The lesions were located between the upper cervical and lower lumbar spine: C1-T1 (n = 6), T5-L3 (n = 11), and L5 (n = 1); they arose intradurally in six patients and extradurally in 12. Thirty-one arteries were embolized with polyvinyl alcohol (PVA) particles (150-500 microm), and, in 18 of these, pieces of gelatin sponge were added for proximal pedicular embolization. The criteria for judging the effectiveness of embolization were completeness of tumor removal and estimated blood loss during surgery.


RESULTS
Tumor embolization was total in eight patients, nearly total in seven, subtotal in one, and partial in two. There were no symptomatic complications associated with embolization. Tumors were totally removed in 17 patients and nearly totally removed in one. The average estimated blood loss during surgery was 1100 mL (range, 200-6000 mL) for all 18 patients, and 1540 mL in patients with extradural tumors.


CONCLUSIONS
Preoperative embolization of hypervascular spinal tumors is safe and effective. It can make complete resection of a tumor possible and can make an unresectable tumor resectable. Superselection or flow control is necessary to achieve effective devascularization and to avoid complications.
Shi
H B
HB
Department of Radiology, First Affiliated Hospital of Nanjing Medical University, China.
Suh
D C
DC
Lee
H K
HK
Lim
S M
SM
Kim
D H
DH
Choi
C G
CG
Lee
C S
CS
Rhim
S C
SC
D000293:Adolescent; D000328:Adult; D000792:Angiography; D016063:Blood Loss, Surgical / Q000503:physiopathology; D002574:Cervical Vertebrae / Q000098:blood supply / Q000000981:diagnostic imaging / Q000601:surgery; D003131:Combined Modality Therapy; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000098:blood supply / Q000000981:diagnostic imaging / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000000981:diagnostic imaging / Q000601:surgery; D013120:Spinal Cord Neoplasms / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000601:surgery; D013125:Spinal Neoplasms / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000601:surgery; D016896:Treatment Outcome