Hypervascular cervical spine metastases: embolization by direct injection of Onyx-18

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• 作者：J. Oppermann ; J. Bredow ; J. Siewe ; P. Eysel ; T. Koy
• 关键词：Onyx ; Direct puncture ; Spinal metastases ; Breast cancer ; Embolization
• 刊名：European Spine Journal
• 出版年：2015
• 出版时间：May 2015
• 年：2015
• 卷：24
• 期：4-supp
• 页码：580-584
• 全文大小：1,513 KB
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• 作者单位：J. Oppermann (1)
  J. Bredow (1)
  J. Siewe (1)
  P. Eysel (1)
  T. Koy (1)
  
  1. Department of Orthopedics and Trauma Surgery, University Hospital of Cologne, Kerpener Strasse 62, 50937, Cologne, Germany
  
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Surgical Orthopedics
  Neurosurgery
  
• 出版者：Springer Berlin / Heidelberg
• ISSN：1432-0932

文摘

Purpose Spinal metastases are common in patients with cancer. Following lung and liver, spine is the most common site for cancers to metastasize. Many of them are hypervascularized. These cases are a particular challenge for the surgeon and represent a significant danger of massive blood loss during surgery. Hypervascularized metastases of the cervical spine also include the risk of postoperative bleeding with severe neurological impairment. Case summary We report a case of a 67-year-old women with breast cancer (BC) metastasis within the vertebral bodies of C3 and C4 with nearly complete bony destruction of the ventral column and intraspinal tumor masses compressing the spinal cord at level C3 and C4. The hypervascularized tumor was supplied by multiple minor vessels from both vertebral arteries, too small to be coiled individually. Due to an allergy to aspirin, intravascular stenting of the vertebral arteries was not an option. We decided to perform a preoperative direct injection of onyx-18 for embolization of the tumor. Conclusion Presurgical direct injection of Onyx-18 for treating hypervascular spinal metastases of breast cancer seems to be an effective and safe technique and reduces intraoperative bleeding to a minimum.