Abstract
Preoperative selective embolisation was carried out on 17 patients with spinal metastases from various primary tumours. There was a significant reduction in the blood loss (2088 ml) and infusion volume requirement (3500 ml) and more favourable postoperative haemoglobin (Hb) development compared with the non-embolised but otherwise identical control group. The reduced intraoperative bleeding manifested itself in the form of greater clarity and a less complicated intraoperative course. Particularly with a dorsal approach, the reduced bleeding permitted more exact preparation and more extensive tumour resection. Preoperative embolisation is thus a valuable aid in spinal metastasis resection. Given suitable indications and exact positioning of the embolising material, no significant complications should arise. The method as a whole calls for close collaboration between interventional radiologists and spinal orthopaedists.
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References
Black P (1979) Spinal metastases: current status and recommended guidelines for management. Neurosurgery 5:726–746
Bowers TA, Murray JA, Charnsangavej C, Soo CS, Cheung VP, Wallace S (1982) Bone metastases from renal cell carcinoma. The pre-operative use of trans-catheter arterial occlusion. J Bone Joint Surg [Am] 64:749–757
Carpenter PR, Ewing JW, Cook AJ, Kuster AH (1977) Angiographic assessment and control of potential operative hemorrhage with pathological fractures secondary to metastases. Clin Orthop 123:6–16
Chuang VP, Wallace S, Swanson D et al (1979) Arterial embolization in the treatment of pain for metastatic renal carcinoma. Radiology 133:611–614
De Cristofaro R, Biagini R, Boriani S et al (1992) Selective arterial embolization in the treatment of aneurysmal bone cyst and angioma of bone. Skeletal Radiol 21:523–527
Enneking JF (1983) Muskuloskeletal surgery. Churchill Livingstone, New York
Feldman F, Casarella WJ, Dick HM, Hollander BA (1975) Selective intraarterial embolization of bone tumors. AJR 123:130–139
Frankel HL, Hancock DO (1969) The value of postural reduction in the initial management of closed injuries of the spine with paraplegia and tetraplegia. Paraplegia 7:179–192
Gellad FE, Sadato N, Numaguchi Y, Levine AM (1990) Vascular metastatic lesions of the spine: preoperative embolization. Radiology 176:683–686
Goldstein HM, Medellin H, Beydour MT, Wallace S (1975) Transcatheter embolization of renal cell carcinoma. AJR 123:557–565
Gradinger RV, Opitz G (1989) Wirbelsäulentumore. Demeter, Graefelfing
Hohmann D, Liebig KJ, Beyer W (1987) Gutartige Tumoren der Wirbelsäule. Orthopade 16:402–414
Mutschler W, Dopfer HP, Kreibich M (1990) Chirurgische Therapie von Wirbelmetastasen. Zentralbl Chir 115:1281–1291
Roscoe MW, McBroom RJ, St Louis E, Grossman H, Perrin R (1989) Preoperative embolization in the treatment of osseous metastases from renal cell carcinoma. Clin Orthop 302–307
Rowe DM, Becker GJ, Rabe FE (1984) Osseous metastases from renal cell carcinoma. Embolization and surgery for restoration of function. Radiology 150:673–679
Sim FH (1988) Diagnosis and management of metastatic bone disease. Raven, New York
Soo CS, Wallace S, Chuang VP, Carrasco CH, Phillies G (1982) Lumbar artery embolization in cancer patients. Radiology 145:655–659
Sundaresan N, Choi IS, Hughes JE, Sachdev VP, Berenstein A (1990) Treatment of spinal metastases from kidney cancer by presurgical embolization and resection. J Neurosurg 73:548–554
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Hess, T., Kramann, B., Schmidt, E. et al. Use of preoperative vascular embolisation in spinal metastasis resection. Arch Orthop Trauma Surg 116, 279–282 (1997). https://doi.org/10.1007/BF00390053
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DOI: https://doi.org/10.1007/BF00390053