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The role of percutaneous transarterial embolization in the management of spinal bone tumors: a literature review

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Abstract

Purpose

Spinal bone tumors include a heterogeneous broad of primary or metastatic lesions that may present as incidental findings or manifest with painful symptoms and pathological fractures. Optimal management of spine bone lesions is often difficult and treatment algorithms are usually solidly based on surgery. We aimed to evaluate the contribution of trans-arterial embolization in this field, with particular attention to the procedure efficacy, technical difficulties and complications.

Methods

We present a literature review on the role of trans-arterial embolization in the management of spinal bone tumors, both primary and metastatic, evaluating its contribution as preoperative treatment, palliative procedure and standalone curative strategy.

Results

Trans-arterial embolization provides an important contribution to reducing surgery hemorrhagic risks, offering a better visualization of the operating field, and possibly increasing tumor susceptibility to chemotherapy or radiation therapy. Nonetheless, it plays an important part in pain palliation, with the unquestionable advantage of being easily repeatable in case of necessity. Its curative role as a standalone therapy is still subject of debate, and at the present time, satisfactory results have been recorded only in the treatment of aneurysmal bone cysts.

Conclusion

Percutaneous trans-arterial embolization has established as a highly useful minimally invasive procedure in the management of spinal bone lesions, particularly as adjuvant preoperative therapy and palliative treatment.

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Authors and Affiliations

  1. Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Via G.C.Pupilli, 1, 40136, Bologna, Italy

    Giancarlo Facchini, Anna Parmeggiani, Giuliano Peta, Claudia Martella, Marco Miceli & Giuseppe Rossi

  2. Department of Experimental, Diagnostic and Specialty Medicine (DIMES), S.Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy

    Anna Parmeggiani & Claudia Martella

  3. Department of Oncological and Degenerative Spine Surgery, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy

    Alessandro Gasbarrini & Gisberto Evangelisti

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  1. Giancarlo Facchini
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  2. Anna Parmeggiani
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  3. Giuliano Peta
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  5. Alessandro Gasbarrini
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  7. Marco Miceli
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Contributions

Conceptualization, GF, GR and AG; Methodology, GF and GE; Investigation, AP and CM; Resources, AP and GP; Writing—Original Draft Preparation, AP and CM; Writing—Review & Editing, GF, GP, MM and GR; Supervision, GF, GP, AG, GE and MM.

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Correspondence to Anna Parmeggiani.

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Facchini, G., Parmeggiani, A., Peta, G. et al. The role of percutaneous transarterial embolization in the management of spinal bone tumors: a literature review. Eur Spine J 30, 2839–2851 (2021). https://doi.org/10.1007/s00586-021-06963-5

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  • DOI: https://doi.org/10.1007/s00586-021-06963-5

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