Introduction: Preoperative embolization has the potential to decrease intraoperative blood loss and facilitate spinal cord decompression and tumor resection .

Methods: A retrospective case review was conducted on patients undergoing preoperative transarterial embolization of a spinal tumor between 1995 and 2012 at our institution.

Results: 30 patients met the inclusion criteria, with a mean age of 60.6 years. Twenty-eight patients had metastatic tumors and 2 patients had hemangiomas. In 14 (50%) patients the metastases were from renal cell carcinomas. 54 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 92.6% with the rest of the embolic agents (p=0.08). The estimated blood loss was 1616 ml (range 350-5000 ml). Blood loss was 1385 cc on average with Onyx versus 1763 with the rest of the embolic agents (p=0.5). 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 vs. 3.10, respectively, p=0.9).

Conclusions: In our experience, the use of transarterial tumor embolization as an adjunct for spinal surgery is safe and effective.

Patient Care: To promote awareness of the safety and efficacy of preoperative embolization of spinal tumors in hopes to lower the morbidity of spinal surgery, particularly intraoperative blood loss.

Learning Objectives: At the conclusion of this presentation, the reader will be familiar with: the use of endovascular embolization of hypervascular extradural spinal tumors with several embolic agents.

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