PREOPERATIVE TRANSARTERIAL EMBOLIZATION OF SPINAL COLUMN NEOPLASMS

PURPOSE: To determine the safety and value of vertebral column emboliz ation before surgical resection of vascular neoplastic disease. PATIEN TS AND METHODS: Thirty preoperative embolization procedures were perfo rmed in 20 patients with vascular neoplasms of the vertebral column (C -2 to sacrum), Fourteen patients had metastatic renal cell carcinoma, Distal embolic agents were used in 27 cases and were coupled with more proximal agents in six, Gelatin pledgets alone were used in three cas es, Twenty-six of the 27 surgical procedures involved partial to compl ete tumor resection. RESULTS: Seventy-two arteries were embolized (one to six per procedure). All surgical procedures were successful, and n one were terminated because of blood loss, Massive blood loss occurred in one patient with paraganglioma, but embolization allowed complete vertebral resection at two levels, When this patient was excluded, blo od loss ranged from 300 to 5,000 mL (mean, 1,871 mL). Transfusions req uired in 22 surgical procedures ranged from 1 to 10 units of packed re d blood cells. Symptoms became worse after embolization in one case bu t improved with surgical decompression. CONCLUSION: Embolization befor e surgery for spinal column neoplasms appears to safely and effectivel y limit blood loss.