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Palliative embolization for metastases of the spine

  • Original Article • SPINE - TUMORS
  • Published:
European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

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.

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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.

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Authors and Affiliations

  1. Department of Diagnostic and Interventional Radiology, Istituto Ortopedico Rizzoli, Bologna, Italy

    Giancarlo Facchini, Milva Battaglia & Cecilia Tetta

  2. Department of Oncology, Saint Orsola-Malpighi Hospital, Bologna, Italy

    Piergiorgio Di Tullio

  3. Poliambulatorio Zappi-Bartalena, Imola, Italy

    Tommaso Bartalena

  4. Department of Orthopaedics, Istituto Ortopedico Rizzoli, Bologna, Italy

    Costantino Errani

  5. First Department of Orthopaedics, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece

    Andreas F. Mavrogenis

  6. Department of Interventional Angiographic Radiology, Istituto Ortopedico Rizzoli, Bologna, Italy

    Giuseppe Rossi

Authors
  1. Giancarlo Facchini
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  2. Piergiorgio Di Tullio
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  3. Milva Battaglia
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  4. Tommaso Bartalena
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  5. Cecilia Tetta
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  6. Costantino Errani
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  7. Andreas F. Mavrogenis
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  8. Giuseppe Rossi
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Corresponding author

Correspondence to Andreas F. Mavrogenis.

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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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Facchini, G., Di Tullio, P., Battaglia, M. et al. Palliative embolization for metastases of the spine. Eur J Orthop Surg Traumatol 26, 247–252 (2016). https://doi.org/10.1007/s00590-015-1726-y

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  • DOI: https://doi.org/10.1007/s00590-015-1726-y

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