Abstract
During surgeries for metastatic vertebral tumor, massive bleeding is a major concern. We retrospectively examined 17 patients who underwent surgeries for metastatic vertebral tumors. As was demonstrated previously, metastasis of hypervascular tumor, operation to lower vertebral lesions, and operation of multiple vertebrae were related to increased volume of bleeding. We also found that patients who received preoperative embolization had more bleeding than those who did not. This may be due to the fact that preoperative embolization was specifically performed when massive bleeding was predicted. We further examined the effectiveness of preoperative embolization and found that the number of embolized segmental arteries was key to bleeding. When adjacent segmental arteries were embolized together with the feeding arteries of the tumor, the volume of bleeding was significantly reduced.
In conclusion, preoperative embolization of multiple segmental arteries is recommended when the patient is at high risk for massive bleeding during a surgery for metastatic vertebral tumor. If such embolization has not been undergone and the tumor has a high risk of massive bleeding, we recommend preparing for massive bleeding with special caution during the surgery.
