Pre-operative embolisation of metastatic spinal tumours has the
potential to decrease intra-operative blood loss. Intra-operative
blood loss is multifactorial and one factor may be the embolisation
technique used. The purpose of this study was to retrospectively
analyse the effect of three different pre-operative embolisation
techniques on intra-operative blood loss, complication rate and
tumour aetiology in patients treated with a corpectomy and
dorsoventral stabilisation at our institution.
We conducted a retrospective analysis of embolisation procedures for
vertebral metastases performed from January 2002 to December 2011.
Only pre-operatively embolised patients treated by a single-level
hemicorpectomy or corpectomy procedure from T4-L5, including
posterior spinal stabilisation using pedicle screws, were included.
All patient charts and examinations were analysed regarding the
embolisation technique, gender, age, primary tumour, time between
the embolisation and surgery, intra-operative blood loss,
intra-operative transfusions and complications related to
We identified a total of 46 patients, 25 male and 21 female
patients. The mean age at the time of surgery was 66 years (range
39-84 years). The tumours treated were: 15 (33%) renal cell
carcinomas, six (13%) breast carcinomas, five (11%) lung carcinomas,
five (11%) urothelial carcinomas, four (9%) myelomas and 11 (24%)
miscellaneous types including rectal carcinoma, thymoma and
melanoma. Embolisation with coils was performed in 23 patients,
particles were used in six and a combination of coils and particles
in 18. The mean time between the embolisation and surgery was 23
hours (range 80-4,430 minutes). The median overall intra-operative
estimated blood loss (EBL) was 2,300 ml (range 500-15,000 ml). In
patients embolised with coils and particles, EBL was 2,200 ml
compared to 1,450 ml in patients embolised with particles and 2,500
ml in the coil group. No statistically significant differences
between the three groups could be detected. There were no
complications related to the embolisation techniques.
Pre-operative embolisation of spinal metastases using coils,
particles or a combination of both is a safe and reproducible
procedure. In our cohort we reported no complications during the
three different embolisation techniques. No statistically
significant difference regarding blood loss between the three
embolisation techniques could be detected. Our data confirm existing
studies concerning the control of intra-operative blood loss using
different embolisation techniques. The benefit of embolisation with
a combination of coils and particles compared to embolisation with
particles only is questionable.
Cernoch P, Hechelhammer L, von Hessling A, Spross C, erhardt j, Jost
B, Külling F A. Pre-operative embolisation of spinal metastasis:
technique, complication rate and outcome-clinical experience. Int
Orthop 2015; 39:1399-404.