Preoperative embolization in spinal and pelvic metastases

Area of Science:

• Oncology
• Interventional Radiology
• Surgical Oncology

Background:

• Spinal and pelvic metastases often present with hypervascularity, complicating surgical resection.
• Minimizing intraoperative blood loss and transfusion requirements is crucial for patient outcomes.

Purpose of the Study:

• To evaluate the efficacy and safety of preoperative embolization in patients undergoing surgery for spinal and pelvic metastases.
• To assess the impact of embolization on intraoperative blood loss, transfusion needs, and operating time.

Main Methods:

• Selective preoperative embolization was performed in 32 patients with spinal (n=21) or pelvic (n=11) metastases.
• Outcomes were compared to a non-embolized control group (spinal n=20, pelvic n=10).
• Key evaluation parameters included intraoperative blood loss, blood transfusion requirements, and operative duration.

Main Results:

• A significant reduction in blood loss and transfusion requirements was observed in both the embolized spinal (P=0.02) and pelvic (P=0.05) groups compared to controls.
• Operating time was shorter in the embolized group, though not statistically significant.
• Two cases in the embolized spinal group required surgical revision due to psoas muscle necrosis; no neurological deficits were attributed to embolization.

Conclusions:

• Preoperative embolization is an effective technique for reducing intraoperative blood loss and transfusion needs in hypervascularized spinal and pelvic metastases.
• The procedure demonstrates a favorable safety profile, with no procedure-related neurological deficits observed.