Preoperative embolization proves effective against non-hypervascular metastatic spine tumors

Lee Han-soo  Published 2019.08.08  14:54  Updated 2019.08.08 16:08


Researchers at St.Mary’s Seoul Hospital have concluded preoperative embolization for non-hypervascular metastatic spine disease (MSD) decreases blood loss, the hospital said Thursday.

Professors Kim Young-hoon (left) and Kim Sang-il

The efficacy of preoperative embolization for hypervascular MSD such as renal cell and thyroid cancers is well known. However, the debate on the effectiveness of preoperative embolization for non-hypervascular MSD had remained unsettled.

To demonstrate the operation’s efficacy, a St. Mary’s research team, led by Professors Kim Young-hoon and Kim Sang-il, analyzed 79 patients -- 36 cases of preoperative embolization and 43 instances of non-embolization -- who underwent surgery for metastatic spine lesions.

The participants had metastatic vertebral tumors with their primary cancer being a non-hypervascular tumor. Primary cancer types were lung cancer (30), liver cancer (14), gastric cancer (9), and other cancers (26). The team excluded representative hypervascular tumors such as renal cell and thyroid cancers.

The demographic data was not significantly different between the embolization and the non-embolization groups. There were no significant differences in intraoperative and perioperative estimated blood losses (EBL), total transfusion, and calibrated EBL between two groups.

However, intraoperative EBL and total transfusion in patients with preoperative embolization were significantly lower than in non-embolization in the corpectomy group.

Also, the team noted the presence of the Adamkiewicz artery at the index level in two patients. Disruption of this major feeder artery resulted in significant changes in intraoperative neuromonitoring.

“With the recent development of embolization, the range of embolization operations has been widened, and the results are also outstanding,” Professor Kim Young-hoon said. “To reduce postoperative complications in patients with non-hypervascular tumors, hospitals should consider an angiography and embolization before metastatic spinal tumor surgery.”

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