The efficacy and risks of preoperative embolization of spinal tumors

Awad, Al Wala; Almefty, Kaith K.; Ducruet, Andrew F; Turner, Jay D.; Theodore, Nicholas; McDougall, Cameron G.; Albuquerque, Felipe C.

doi:10.1136/neurintsurg-2015-011833

Cited by 27 publications

(35 citation statements)

References 20 publications

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“…3 While early reports on preoperative embolization of spinal metastases date around 1993, the majority were published after 2010. 3,13,14 This trend in the literature parallels the trend identified in our study of increased utilization of preoperative embolization for spinal metastases. Several factors are responsible for this observation.…”

Section: Discussionsupporting

confidence: 82%

Trends in Utilization of Preoperative Embolization for Spinal Metastases: A Study of the National Inpatient Sample 2005–2017

et al. 2021

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Purpose: While previous studies have suggested that preoperative embolization of hypervascular spinal metastases may alleviate intraoperative blood loss and improve resectability, trends and driving factors for choosing this approach have not been extensively explored. Therefore, we evaluated the trends and assessed the factors associated with preoperative embolization utilization for spinal metastatic tumors using a national inpatient database.Materials and Methods: The National Inpatient Sample database of the Healthcare Cost and Utilization Project was queried for patients undergoing surgical resection for spinal metastasis between January 1, 2005 and December 31, 2017. Patients undergoing preoperative embolization were identified; trends in the utilization of preoperative embolization were analyzed using the Cochran-Armitage test. Multivariable regression was conducted to assess factors associated with higher preoperative embolization utilization.Results: A total of 11,508 patients with spinal metastasis were identified; 105 (0.91%) underwent preoperative embolization. Of those 105 patients, 79 (75.24%) patients had a primary renal cancer, as compared to 1,732 (15.19%) of those who did not undergo preoperative embolization (P<0.001). The majority of patients in the non-preoperative embolization cohort had a primary lung tumor (n=3,562, 31.24%). Additionally, patient comorbidities were similar among the 2 groups (P>0.05). Trends in preoperative embolization indicated an increase of 0.16% (standard error: 0.024%, P<0.001) in utilization per year.Conclusion: Utilization of preoperative embolization for spinal metastasis is increasing yearly, especially for patients with renal cancer, suggesting that surgeons may increasingly consider embolization before surgical resection for hypervascular tumors. Additionally, the literature has shown the intraoperative and postoperative benefits of this procedure.

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Section: Discussionsupporting

confidence: 82%

Trends in Utilization of Preoperative Embolization for Spinal Metastases: A Study of the National Inpatient Sample 2005–2017

et al. 2021

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“…Terdapat banyak informasi yang dapat diperoleh dari berbagai kasus yang disajikan dalam penelitan ini, seperti keuntungan maupun kerugian embolisasi, komplikasi, bahan embolan, timing embolisasi, dan lainnya. [10][11][12][13][14][15][16] Pada era modern dewasa ini, para tenaga kesehatan dituntut untuk memaksimalkan fasilitas yang ada dengan tujuan mengurangi morbiditas pasien, salah satunya yaitu memaksimalkan tindakan minimal invasif seperti embolisasi preoperatif yang dapat mengurangi perdarahan intraoperatif pada tulang belakang. Seiring berjalannya waktu, embolisasi preoperatif telah dikembangkan untuk mengurangi jumlah perdarahan pada operasi dekompresi tulang belakang.…”

Section: Pendahuluanunclassified

“…Semua penelitian yang dikaji memberikan informasi tentang teknik dan pendekatan yang sama. [10][11][12][13][14][15][16] Hal yang berbeda ialah bahan embolan yang digunakan. Coiling paling sering digunakan karena aman dan jarang terjadi perpindahan coiling ke tempat lain yang tidak diinginkan, disusul oleh onyx®(Medtronic), embosphere, dan PVA.…”

Section: Bahasanunclassified

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Embolisasi Preoperatif pada Operasi Dekompresi Tulang Belakang

Pali

Prasetyo

Suharso

et al. 2021

eCL

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Embolization is an effective way of controlling bleeding. This study was aimed to provide some information about preoperative spinal embolization, embolization materials, and complications. This was a literature review study using an online journal database and Google Scholar. The keywords used were Preoperative Spinal Embolization. The feasibility of the selected studies were case reports. The results showed that all studies used the same technique and approach to achieve different goals. The difference among them was the choice of embolan material. The complications that arose were few and could be managed. In conclusion, preoperative spinal embolization is the choice of therapy that give more benefit and safety.Keywords: preoperative spinal embolization; spinal decompression surgery; embolan Abstrak: Embolisasi merupakan cara yang efektif dalam mengontrol perdarahan. Penelitian ini bertujuan memberikan informasi mengenai embolisasi tulang belakang, bahan embolan, dan komplikasi yang ditimbulkan. Jenis penelitian ialah suatu literature review menggunakan database jurnal online dan Google Scholar. Pencarian data menggunakan kata kunci Preoperative Spinal Embolization. Kelayakan penelitian yang dipilih bersifat case report. Hasil penelitian mendapatkan bahwa semua penelitian menggunakan teknik dan pendekatan yang sama untuk mencapai tujuan yang berbeda. Perbedaannya ialah dalam hal pemilihan bahan embolan. Komplikasi yang terjadi hanya sedikit dan dapat diatasi. Simpulan penelitian ini ialah preoperative spinal embolization merupakan terapi pilihan yang menguntungkan dan aman.Kata kunci: embolisasi preoperatif; operasi dekompresi tulang belakang; embolan

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“…Durch intraoperatives Neuromonitoring konnten insbesondere in der intraspinalen Tumorchirurgie und der Deformitätenchirurgie die Behandlungserbnisse verbessert werden [41,42]. Darüber hinaus können durch eine präoperative Embolisation im Rahmen von Operationen von hypervaskularisierten Tumoren die Operationszeit und der Blutverlust relevant gesenkt werden bei lediglich geringer Komplikationsrate [43,44]. abzuhängen.…”

Section: Verfahrenswahlunclassified

Outcome-relevante Faktoren in der Wirbelsäulenchirurgie

Spiegl¹,

Josten²,

Heyde³

2020

Die Wirbelsäule

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Several parameters might influence the outcome after vertebral spine surgeries. In order to find these a systematic literature search was performed. Thereby, a total of 62 articles were selected. All outcome-relevant parameters were categorized into patient-specific, course-specific, and radiologic parameters. Furthermore, scores were included which help to estimate the risk of adverse events and outcome for certain pathologies and/or surgeries. Patient-specific parameters were predominantly the patient age and several specific secondary diagnoses such as diabetes, adipositas, depression, anxiety disorders, and nicotine abuse. Additionally, the patient expectation plays an important role in the subjective outcome assessment. Course-specific parameters are mainly perioperative factors such as surgical experience, particularly in highly demanding vertebral spine surgeries. Furthermore, modern intraoperative equipment such as intraoperative CT and neuromonitoring helps to increase patient safety. The most outcome-relevant radiologic parameters are those which define the sagittal balance. Thereby, a correct sagittal balance is associated with superior clinical outcomes.

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The efficacy and risks of preoperative embolization of spinal tumors

Abstract: Spinal tumor embolization is a safe procedure, is associated with few complications, and may improve surgical outcomes by limiting intraoperative blood loss and reducing operative time.

Cited by 27 publications

References 20 publications

Trends in Utilization of Preoperative Embolization for Spinal Metastases: A Study of the National Inpatient Sample 2005–2017

Trends in Utilization of Preoperative Embolization for Spinal Metastases: A Study of the National Inpatient Sample 2005–2017

Embolisasi Preoperatif pada Operasi Dekompresi Tulang Belakang

Outcome-relevante Faktoren in der Wirbelsäulenchirurgie

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