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Palliative embolization for metastases of the spine

  • Giancarlo Facchini
  • Piergiorgio Di Tullio
  • Milva Battaglia
  • Tommaso Bartalena
  • Cecilia Tetta
  • Costantino Errani
  • Andreas F. MavrogenisEmail author
  • Giuseppe Rossi
Original Article • SPINE - TUMORS

Abstract

Background

To present palliative selective and superselective arterial embolization with N-butyl-cyanoacrylate for cancer patients with spinal metastases.

Materials and methods

We studied the files of 164 cancer patients (94 men and 70 women; mean age 57.6 years; range 35–81 years) treated from March 2003 to March 2013 with 178 selective arterial embolization procedures for metastases of the spine from variable primary cancers. We evaluated the technical success of the embolization procedure with post-procedural angiography, the clinical effect in pain relief, need for analgesics and tumor size reduction, and the embolization-related complications.

Results

Post-embolization angiography showed complete occlusion of the pathological feeding vessels in all procedures. Pain score and need for analgesics reduced by 50 % in 159 patients (97 %); no response was achieved in five patients with metastases of the sacrum. The mean duration of pain relief was 9.2 months (range 1–12 months). Metastatic tumor size reduced from a mean of 5.5 cm (range 3.5–7.5 cm) pre-embolization to a mean of 4.5 cm (range 3–5 cm) at the 6-month follow-up; the difference was not statistically significant. Ninety-three patients (56.7 %) experienced embolization-related complications the most common being post-embolization syndrome (80 patients, 48.8 %) followed by leg paresthesias (ten patients, 6 %), and rupture of a lumbar artery (one patient, 0.6 %).

Conclusion

Selective arterial embolization with N-butyl-cyanoacrylate should be considered for pain palliation of patients with metastases of the spine. However, pain relief is temporary, and complications, although minor may occur.

Keywords

Embolization Metastasis Spine Pain Palliation 

Notes

Acknowledgments

In memory of Professor Andrea Facchini, who died on July 13, 2014, from complications of cancer after devoting his life to science and education in medicine.

Compliance with ethical standards

Conflict of interest statement

No benefits have been or will be received from a commercial party related directed or indirectly to the subject matter of this article.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Copyright information

© Springer-Verlag France 2015

Authors and Affiliations

  • Giancarlo Facchini
    • 1
  • Piergiorgio Di Tullio
    • 2
  • Milva Battaglia
    • 1
  • Tommaso Bartalena
    • 3
  • Cecilia Tetta
    • 1
  • Costantino Errani
    • 4
  • Andreas F. Mavrogenis
    • 5
    Email author
  • Giuseppe Rossi
    • 6
  1. 1.Department of Diagnostic and Interventional RadiologyIstituto Ortopedico RizzoliBolognaItaly
  2. 2.Department of OncologySaint Orsola-Malpighi HospitalBolognaItaly
  3. 3.Poliambulatorio Zappi-BartalenaImolaItaly
  4. 4.Department of OrthopaedicsIstituto Ortopedico RizzoliBolognaItaly
  5. 5.First Department of Orthopaedics, Attikon University HospitalNational and Kapodistrian University of AthensAthensGreece
  6. 6.Department of Interventional Angiographic RadiologyIstituto Ortopedico RizzoliBolognaItaly

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