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

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 bas...

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Bibliographic Details
Published in:European spine journal 2021-10, Vol.30 (10), p.2839-2851
Main Authors: Facchini, Giancarlo, Parmeggiani, Anna, Peta, Giuliano, Martella, Claudia, Gasbarrini, Alessandro, Evangelisti, Gisberto, Miceli, Marco, Rossi, Giuseppe
Format: Article
Language:English
Subjects:
Aneurysm
Bone cancer
Bone lesions
Bone tumors
Chemotherapy
Cysts
Embolization
Fractures
Hemorrhage
Literature reviews
Medicine
Medicine & Public Health
Metastases
Metastasis
Neurosurgery
Palliation
Radiation therapy
Review Article
Spinal cancer
Surgery
Surgical Orthopedics
Tumors
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Summary: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.
ISSN:0940-6719
1432-0932
DOI:10.1007/s00586-021-06963-5