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Preoperative spinal tumor embolization: an institutional experience with Onyx.

Publication ,  Journal Article
Ghobrial, GM; Chalouhi, N; Harrop, J; Dalyai, RT; Tjoumakaris, S; Gonzalez, LF; Hasan, D; Rosenwasser, RH; Jabbour, P
Published in: Clin Neurol Neurosurg
December 2013

BACKGROUND: Preoperative embolization has the potential to decrease intraoperative blood loss and facilitate spinal cord decompression and tumor resection. OBJECTIVE: We report our institutional experience with the embolization of hypervascular extradural spinal tumors with Onyx as well as earlier embolic agents in a series of 28 patients. 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: Twenty-eight patients met the inclusion criteria, with a mean age of 60.6 years. Twenty-eight patients had metastatic tumors. In 14 (50%) patients the metastases were from renal cell carcinomas. Fifty-four 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 92.7% with the rest of the embolic agents (p=0.08). The estimated blood loss was 1616ml (range 350-5000ml). Blood loss was 750cm(3) on average with Onyx versus 1844 with the rest of the embolic agents (p=0.14). 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 versus 3.10, respectively, p=0.9). CONCLUSION: In our experience, the use of transarterial tumor embolization as an adjunct for spinal surgery is a safe and feasible option.

Duke Scholars

Published In

Clin Neurol Neurosurg

DOI

EISSN

1872-6968

Publication Date

December 2013

Volume

115

Issue

12

Start / End Page

2457 / 2463

Location

Netherlands

Related Subject Headings

  • Tantalum
  • Spinal Neoplasms
  • Retrospective Studies
  • Polyvinyls
  • Neurosurgical Procedures
  • Neurology & Neurosurgery
  • Middle Aged
  • Male
  • Magnetic Resonance Angiography
  • Humans
 

Citation

APA
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ICMJE
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Ghobrial, G. M., Chalouhi, N., Harrop, J., Dalyai, R. T., Tjoumakaris, S., Gonzalez, L. F., … Jabbour, P. (2013). Preoperative spinal tumor embolization: an institutional experience with Onyx. Clin Neurol Neurosurg, 115(12), 2457–2463. https://doi.org/10.1016/j.clineuro.2013.09.033
Ghobrial, George M., Nohra Chalouhi, James Harrop, Richard T. Dalyai, Stavropoula Tjoumakaris, L Fernando Gonzalez, David Hasan, Robert H. Rosenwasser, and Pascal Jabbour. “Preoperative spinal tumor embolization: an institutional experience with Onyx.Clin Neurol Neurosurg 115, no. 12 (December 2013): 2457–63. https://doi.org/10.1016/j.clineuro.2013.09.033.
Ghobrial GM, Chalouhi N, Harrop J, Dalyai RT, Tjoumakaris S, Gonzalez LF, et al. Preoperative spinal tumor embolization: an institutional experience with Onyx. Clin Neurol Neurosurg. 2013 Dec;115(12):2457–63.
Ghobrial, George M., et al. “Preoperative spinal tumor embolization: an institutional experience with Onyx.Clin Neurol Neurosurg, vol. 115, no. 12, Dec. 2013, pp. 2457–63. Pubmed, doi:10.1016/j.clineuro.2013.09.033.
Ghobrial GM, Chalouhi N, Harrop J, Dalyai RT, Tjoumakaris S, Gonzalez LF, Hasan D, Rosenwasser RH, Jabbour P. Preoperative spinal tumor embolization: an institutional experience with Onyx. Clin Neurol Neurosurg. 2013 Dec;115(12):2457–2463.
Journal cover image

Published In

Clin Neurol Neurosurg

DOI

EISSN

1872-6968

Publication Date

December 2013

Volume

115

Issue

12

Start / End Page

2457 / 2463

Location

Netherlands

Related Subject Headings

  • Tantalum
  • Spinal Neoplasms
  • Retrospective Studies
  • Polyvinyls
  • Neurosurgical Procedures
  • Neurology & Neurosurgery
  • Middle Aged
  • Male
  • Magnetic Resonance Angiography
  • Humans