The effectiveness and the factors affecting the result of preoperative transarterial embolization of Spinal Tumors

Purpose: To evaluate the effectiveness of preoperative transarterial embolization of spinal tumors and the factors influencing subsequent surgical outcomes. Materials and Methods: We retrospectively reviewed the medical records of 22 patients who underwent preoperative embolization and surgery for a spinal malignancy from March 2005 to July 2014. Angiographic assessment of the main nutrient artery and bone tumor vascularity was performed, followed by tumor embolization using micro-coils, Gelfoam, or polyvinyl alcohol. Tumor staining was evaluated before the procedure was finished. Results: Embolization was successful in 20/22 (91%) patients and partially successful in 2/22 (9%). The average intraoperative blood loss was 2,658 mL among all patients. Intraoperative blood loss was lower in patients with successful embolization than in those with partial embolization although the difference was not statistically significant. Embolization using only microcoils resulted in more intraoperative blood loss than embolization with microcoils and Gelfoam, or microcoils and polyvinyl alcohol but the difference was not significant. Patients involving one vertebra showed less blood loss than those involving two vertebrae but this difference also was not statistically significant (p > 0.05). Conclusions: Although there was no statistically significant difference in the reduction of blood loss during surgery due to the embolic agent, degree of embolization, or the number of involved vertebrae, preoperative transarterial embolization of spine tumors is an effective method for reducing intraoperative blood loss in subsequent surgical resections.