Postembolization paralysis in a man with a thoracolumbar giant cell tumor.
Giant cell tumors are hypervascular tumors that represent approximately 5% of all primary bone neoplasms. Vertebral tumors often require surgery to maintain spinal stability or to relieve spinal cord and nerve root compression. However, surgical resection of hypervascular tumors like giant cell tumors can be hazardous because of the risk of excessive intraoperative hemorrhage. Preoperative embolization can be useful to decrease perioperative blood loss in primary and metastatic vertebral tumors, and preoperative embolization for vertebral tumor surgery is relatively safe. We report a patient who had the unusual but serious complications of paralysis and paresthesia at the T12 vertebra and below as a result of preoperative embolization. At 6 months followup, the patient was disease-free but without neurologic function from T12 and below. Therefore, it is imperative physicians be aware of the possible preoperative embolization complication of cord infarction and the safety measures proposed in this article to avoid this complication.
Finstein
Joseph L
JL
Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA, USA.
Chin
Kingsley R
KR
Alvandi
Firoozeh
F
Lackman
Richard D
RD
D016063:Blood Loss, Surgical / Q000517:prevention & control; D004621:Embolization, Therapeutic / Q000009:adverse effects*; D018212:Giant Cell Tumor of Bone / Q000098:blood supply / Q000601:surgery*; D006801:Humans; D008159:Lumbar Vertebrae; D008297:Male; D008875:Middle Aged; D010243:Paralysis / Q000209:etiology*; D011300:Preoperative Care; D013125:Spinal Neoplasms / Q000098:blood supply / Q000601:surgery*; D013904:Thoracic Vertebrae