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Preoperative spinal tumor embolization: an institutional experience with Onyx
George M Ghobrial1, Nohra Chalouhi, James Harrop
1Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, USA.
Clinical Neurology and Neurosurgery
|October 31, 2013
Summary
Transarterial embolization effectively reduces blood loss during spinal tumor surgery. This procedure, using agents like Onyx, is safe and feasible for hypervascular extradural spinal tumors.
Area of Science:
- Neurosurgery
- Interventional Radiology
- Oncology
Background:
- Preoperative embolization can reduce intraoperative blood loss.
- It facilitates spinal cord decompression and tumor resection.
Purpose of the Study:
- To report institutional experience with embolizing hypervascular extradural spinal tumors.
- To evaluate embolization using Onyx and earlier agents in 28 patients.
Main Methods:
- Retrospective case review of patients undergoing spinal tumor embolization (1995-2012).
- Analysis of embolization agents used, including Onyx, PVA, NBCA, coils, and embospheres.
Main Results:
- Twenty-eight patients with metastatic tumors (50% renal cell carcinoma) were included.
- Embolization achieved an average 97.8% decrease in tumor blush with Onyx.
- Onyx use was associated with lower average blood loss (750cm³ vs. 1844cm³).
- Zero mortality and no significant change in modified Rankin Score (mRS) were observed.
Conclusions:
- Transarterial tumor embolization is a safe and feasible adjunct for spinal surgery.
- Onyx demonstrated promising results in reducing blood loss and tumor blush.
