title: Risk factors for major complications in surgery for hypervascular spinal tumors: an analysis of 120 cases with adjuvant preoperative embolization.
abstract: OBJECTIVE
  To determine the frequency of major complications and identify related risk factors in surgery for hypervascular spinal tumors after preoperative selective arterial embolization.
  
  
  METHODS
  Patients with spinal tumors who underwent preoperative embolizations between January 2010 and March 2013 were retrospectively reviewed. Perioperative complications were classified as either major or minor. Preoperative and intraoperative factors were analyzed for any association with major complications using univariate and multivariate regression analysis.
  
  
  RESULTS
  There were 120 embolizations with subsequent 120 spine operations that met the inclusion and exclusion criteria. Overall, 27.5% (33/120) experienced major complications and 11.7% (14/120) had at least two major complications. Respiratory complications were the most commonly seen with a rate of 10.8% (13/120). Multivariate regression analysis identified two risk factors for major complications: reoperation and higher score of surgical invasiveness index. Two risk factors were identified for two or more major complications: age≥65 years and higher score of surgical invasiveness index. Two risk factors were identified for major respiratory complications: thoracic surgery and higher score of surgical invasiveness index. However, embolization-related factors did not reach significance in the multiple regression model.
  
  
  CONCLUSIONS
  Major complications in surgery for hypervascular spinal tumors after embolization are prevalent. Risk factors identified in this study are useful prognostic indicators when considering surgical treatment combined with embolization.
authors.affiliation: Musculoskeletal Tumor Center, People's Hospital, Peking University, Xizhimen Nan 11#, Xicheng District, 100044, Beijing, China.
authors.forename: Benqiang
authors.initials: B
authors.lastname: Tang
authors.affiliation: Musculoskeletal Tumor Center, People's Hospital, Peking University, Xizhimen Nan 11#, Xicheng District, 100044, Beijing, China.
authors.forename: Tao
authors.initials: T
authors.lastname: Ji
authors.affiliation: Musculoskeletal Tumor Center, People's Hospital, Peking University, Xizhimen Nan 11#, Xicheng District, 100044, Beijing, China.
authors.forename: Xiaodong
authors.initials: X
authors.lastname: Tang
authors.affiliation: Department of Radiology, People's Hospital, Peking University, Xizhimen Nan 11#, Xicheng District, 100044, Beijing, China.
authors.forename: Long
authors.initials: L
authors.lastname: Jin
authors.affiliation: Musculoskeletal Tumor Center, People's Hospital, Peking University, Xizhimen Nan 11#, Xicheng District, 100044, Beijing, China.
authors.forename: Sen
authors.initials: S
authors.lastname: Dong
authors.affiliation: Musculoskeletal Tumor Center, People's Hospital, Peking University, Xizhimen Nan 11#, Xicheng District, 100044, Beijing, China. bonetumor@163.com.
authors.forename: Wei
authors.initials: W
authors.lastname: Guo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000009:adverse effects*; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D013125:Spinal Neoplasms / Q000098:blood supply / Q000453:epidemiology / Q000473:pathology / Q000628:therapy; D055815:Young Adult
keywords: Major complication; Risk factor; Selective arterial embolization; Spinal tumor; Spine surgery