Abstract
Embolization for spinal neoplasms is mainly employed preoperatively to reduce adverse blood loss during the surgery, especially total en bloc spondylectomy (TES). We review the frequency of spinal neoplasms, indication and efficacy of TES and preoperative embolization, features of spinal vascular anatomy, technical aspects of embolization, adjuvant embolization for giant cell tumor of spinal vertebrae, and future perspectives based on our experience with these issues to enhance understanding on the side of subscribers. Preoperative embolization is not indicated for all neoplasms in the spinal column but for hypervascular ones as its efficacy was reported mainly with the latter subset of tumors. Features of spinal vascular anatomy are as follow: feeding arteries of the spinal vertebrae are fine in their caliber and directly arise from the aorta; they give rise to arteries feeding the spinal cord; they are connected with each other via abundant collateral anastomoses. Technical aspects of embolization are described in relation to these anatomical characteristics: for example, one should not be content to find that Adamkiewicz artery is not depicted in the arteriography of the target segmental arteries, but should go further to locate which segmental artery gives rise to Adamkiewicz artery.
