Preoperative Embolization of Spinal Metastatic Tumor: The Use of Selective Computed Tomography Angiography for the Detection of Radiculomedullary Arteries
Open Access
- 27 July 2021
- journal article
- research article
- Published by Japanese Society for Spine Surgery and Related Research in Spine Surgery and Related Research
- Vol. 5 (4), 284-291
- https://doi.org/10.22603/ssrr.2020-0202
Abstract
Introduction: Preoperative embolization for metastatic spinal cord compression (MSCC) has a risk of spinal ischemia. This study aimed to assess the efficacy and safety of preoperative embolization in patients with MSCC and evaluate the use of computed tomography (CT) angiography for the detection of the radiculomedullary arteries (RMA). Methods: This retrospective study included 20 patients (12 men and 8 women; median age, 66 years), who underwent preoperative embolization before a decompression surgery, which corresponded to 22 embolization procedures. The detection ability of RMA was evaluated using angiography and selective CT angiography. Surgical data including intraoperative blood loss and transfusion were also evaluated. Results: Six RMAs were identified at the levels of affected vertebrae and one level above and below in the diagnostic spinal angiography. In addition to spinal angiography, adjunctive selective CT angiography allowed visualization of another five RMAs. Overall, 11 RMAs were identified in 9 patients. Preoperative embolization was successfully achieved in all patients. As regards complications related to embolization procedure, palsy exacerbated in one patient (4.5%), which improved postoperatively. During the surgical procedure, the mean intraoperative blood loss was 353.4 ± 254.2 mL without intraoperative transfusion in all patients. Conclusion: The present study showed small amounts of intraoperative blood loss without any severe complications related to preoperative embolization. Selective CT angiography was a useful technique to detect RMAs and contributed to the safety of preoperative embolization.Keywords
This publication has 31 references indexed in Scilit:
- The role of preoperative transarterial embolization in spinal tumors. A large single-center experienceThe Spine Journal, 2013
- Spinal ventral epidural arteriovenous fistulas of the lumbar spine: angioarchitecture and endovascular treatmentNeuroradiology, 2013
- Reliability analysis of the epidural spinal cord compression scaleJournal of Neurosurgery: Spine, 2010
- Health‐related quality of life in patients with spinal metastases treated with or without spinal surgeryCancer, 2010
- 3D C-Arm Conebeam CT Angiography as an Adjunct in the Precise Anatomic Characterization of Spinal Dural Arteriovenous FistulasAmerican Journal of Neuroradiology, 2009
- Three-dimensional C-arm Cone-beam CT: Applications in the Interventional SuiteJournal of Vascular and Interventional Radiology, 2009
- Efficacy of DynaCT Digital Angiography in the Detection of the Fistulous Point of Dural Arteriovenous FistulasAmerican Journal of Neuroradiology, 2009
- Does spinal surgery improve the quality of life for those with extradural (spinal) osseous metastases? An international multicenter prospective observational study of 223 patientsJournal of Neurosurgery: Spine, 2008
- Metastatic renal cell carcinoma of the spine: surgical treatment and resultsJournal of Neurosurgery: Spine, 2001
- The value of postural reduction in the initial management of closed injuries of the spine with paraplegia and tetraplegiaSpinal Cord, 1969