Journal article
Preoperative spinal tumor embolization: An institutional experience with Onyx
Clinical neurology and neurosurgery, Vol.115(12), pp.2457-2463
12/2013
DOI: 10.1016/j.clineuro.2013.09.033
PMID: 24169150
Abstract
Preoperative embolization has the potential to decrease intraoperative blood loss and facilitate spinal cord decompression and tumor resection.
We report our institutional experience with the embolization of hypervascular extradural spinal tumors with Onyx as well as earlier embolic agents in a series of 28 patients.
A retrospective case review was conducted on patients undergoing preoperative transarterial embolization of a spinal tumor between 1995 and 2012 at our institution.
Twenty-eight patients met the inclusion criteria, with a mean age of 60.6 years. Twenty-eight patients had metastatic tumors. In 14 (50%) patients the metastases were from renal cell carcinomas. Fifty-four vessels were embolized using PVA, NBCA, Onyx, coils, or embospheres. Sixteen patients were treated with Onyx, 6 patients with PVA, 3 patients with embospheres, 2 patients with NBCA, and 3 patients with a combination of embolic agents. The average decrease in tumor blush was 97.8% with Onyx versus 92.7% with the rest of the embolic agents (p=0.08). The estimated blood loss was 1616ml (range 350–5000ml). Blood loss was 750cm3 on average with Onyx versus 1844 with the rest of the embolic agents (p=0.14). The mean length of stay was 16 days. The mortality rate was zero. Pre- and post-operative modified Rankin Score (mRS) did not differ significantly in the series (3.12 versus 3.10, respectively, p=0.9).
In our experience, the use of transarterial tumor embolization as an adjunct for spinal surgery is a safe and feasible option.
Details
- Title: Subtitle
- Preoperative spinal tumor embolization: An institutional experience with Onyx
- Creators
- George M Ghobrial - Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, USANohra Chalouhi - Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, USAJames Harrop - Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, USARichard T Dalyai - Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, USAStavropoula Tjoumakaris - Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, USAL. Fernando Gonzalez - Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, USADavid Hasan - Department of Neurosurgery, University of Iowa, Iowa City, USARobert H Rosenwasser - Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, USAPascal Jabbour - Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, USA
- Resource Type
- Journal article
- Publication Details
- Clinical neurology and neurosurgery, Vol.115(12), pp.2457-2463
- Publisher
- Elsevier B.V
- DOI
- 10.1016/j.clineuro.2013.09.033
- PMID
- 24169150
- ISSN
- 0303-8467
- eISSN
- 1872-6968
- Language
- English
- Date published
- 12/2013
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Neurosurgery; Otolaryngology
- Record Identifier
- 9984040291402771
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