Preoperative transarterial embolization of spinal tumor: embolization techniques and results.
Preoperative transarterial embolization of spinal tumor: embolization techniques and results.
复制标题
脊柱肿瘤术前经动脉栓塞：栓塞技术和结果。
DOI：
--
复制
发表时间：
1999
期刊：
影响因子：
--
通讯作者：
S. Rhim
中科院分区：
文献类型：
--
作者：
Hai;D. Suh;H. K. Lee;S. Lim;Dae Hong Kim;C. Choi;Choon;S. Rhim
背景和目的
术前栓塞技术的多血供脊髓肿瘤，这已被称为是有助于完成肿瘤切除，尚未详细描述。本研究的目的是分析术前经动脉栓塞治疗富血供脊髓肿瘤的技术，并评价其安全性和价值。
方法
18例富血供脊髓肿瘤患者在手术前接受了经动脉栓塞。病变位于上颈椎和下腰椎之间：C1-T1（n = 6）、T5-L3（n = 11）和L5（n = 1）; 6例患者发生于硬膜内，12例发生于硬膜外。用聚乙烯醇（PVA）颗粒（150-500 μ m）栓塞31条动脉，其中18条添加明胶海绵用于近端椎弓根栓塞。判断栓塞有效性的标准是肿瘤切除的完整性和术中估计的失血量。
结果
肿瘤栓塞在8名患者中是完全的，在7名患者中几乎是完全的，在1名患者中是次全的，在2名患者中是部分的。没有与栓塞相关的症状性并发症。肿瘤全切除17例，近全切除1例。所有18例患者术中平均估计失血量为1100 mL（范围：200-6000 mL），硬膜外肿瘤患者为1540 mL。
结论
富血供脊髓肿瘤的术前栓塞是安全有效的。它可以使肿瘤完全切除成为可能，也可以使不能切除的肿瘤切除。超选择或流量控制是必要的，以实现有效的断流术，避免并发症。
BACKGROUND AND PURPOSE
The techniques of preoperative embolization of hypervascular spinal tumors, which has been known to be helpful for completing tumor resection, have not been described in detail. The purpose of this study was to analyze the technique and to evaluate the safety and value of preoperative transarterial embolization of hypervascular spinal tumors.
METHODS
Eighteen patients with hypervascular spinal tumors underwent transarterial embolization before surgery. The lesions were located between the upper cervical and lower lumbar spine: C1-T1 (n = 6), T5-L3 (n = 11), and L5 (n = 1); they arose intradurally in six patients and extradurally in 12. Thirty-one arteries were embolized with polyvinyl alcohol (PVA) particles (150-500 microm), and, in 18 of these, pieces of gelatin sponge were added for proximal pedicular embolization. The criteria for judging the effectiveness of embolization were completeness of tumor removal and estimated blood loss during surgery.
RESULTS
Tumor embolization was total in eight patients, nearly total in seven, subtotal in one, and partial in two. There were no symptomatic complications associated with embolization. Tumors were totally removed in 17 patients and nearly totally removed in one. The average estimated blood loss during surgery was 1100 mL (range, 200-6000 mL) for all 18 patients, and 1540 mL in patients with extradural tumors.
CONCLUSION
Preoperative embolization of hypervascular spinal tumors is safe and effective. It can make complete resection of a tumor possible and can make an unresectable tumor resectable. Superselection or flow control is necessary to achieve effective devascularization and to avoid complications.