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Neoadjuvant Arterial Embolization of Spine Metastases Associated With Improved Local Control in Patients Receiving
Mark A Damante1, David Gibbs2, Khaled Dibs3
1Department of Neurological Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA.
Neurosurgery
|March 2, 2023
Summary
Preoperative embolization improved local control and pain in spine metastasis patients undergoing surgery and SBRT. This technique shows promise for enhancing treatment outcomes in spinal tumors.
Area of Science:
- Oncology
- Interventional Radiology
- Neurosurgery
Background:
- Spine metastases cause significant pain, instability, and neurological issues.
- Local control (LC) of spine metastases is enhanced by systemic therapies, radiation, and surgical techniques.
- Preoperative arterial embolization may improve LC and pain control.
Purpose of the Study:
- To evaluate neoadjuvant embolization's role in LC of spinal metastases.
- To assess the impact of embolization on pain control in patients receiving surgery and SBRT.
Main Methods:
- Retrospective review of 117 patients with spinal metastases (2012-2020).
- Comparison of outcomes between patients who received preoperative embolization plus surgery and SBRT versus surgery and SBRT alone.
- Assessment of local control, pain scores (Defensive Veterans Pain Rating Scale), and analgesic use.
Main Results:
- Preoperative embolization (47 patients) was associated with improved median LC (14.2 months) compared to no embolization (70 patients, 6.3 months).
- ≥82.5% embolization predicted significantly improved LC (AUC = 0.808, P < .0001).
- Embolization significantly decreased pain scores (P < .001).
Conclusions:
- Preoperative embolization is linked to better local control and pain management for spine metastases.
- Embolization may play a novel role in multimodal treatment strategies for spinal tumors.
- Further prospective studies are recommended to confirm these findings.
