P25. Preoperative embolization in surgical treatment of spinal metastases originating from primary non-thyroid and non-renal cell tumors

Abstract

<h3>BACKGROUND CONTEXT</h3> Preoperative embolization (PE) reduces intraoperative blood loss during surgery for spinal metastases of primary thyroid and renal cell tumors. However, most spine metastases originate from primary breast, prostate, and lung tumors and it remains unclear whether these and other spine metastases benefit from PE. <h3>PURPOSE</h3> To assess whether PE reduces the amount of intraoperative blood loss in patients with spine metastases originating from primary non-thyroid and non-renal cell tumors. <h3>STUDY DESIGN/SETTING</h3> A retrospective study from two affiliated tertiary care orthopedic oncology referral centers. <h3>PATIENT SAMPLE</h3> This study contained a total of 387 patients who underwent surgery for spine metastases between June 2001 and June 2014; 56 with PE and 331 without PE. <h3>OUTCOME MEASURES</h3> The estimated amount of intraoperative blood loss. <h3>METHODS</h3> Operative notes were used to determine the estimated amount of intraoperative blood loss. Multivariable analysis was used to assess whether PE was independently associated with the estimated amount of intraoperative blood loss. <h3>RESULTS</h3> PE was not independently associated with the estimated amount of intraoperative blood loss (95% Confidence Interval [CI] -0.02 – 0.58; p=0.07). Factors independently associated with the estimated amount of intraoperative blood loss included the cervical region of the spine (<0.001), the duration of surgery (<0.001), two levels of the spine operated upon (0.035) and adenocarcinoma as opposed to other primary tumors as the primary tumor of origin (p=0.045). <h3>CONCLUSIONS</h3> Preoperative embolization before surgery on non-thyroid and non-renal cell spine metastases does not significantly influence the estimated amount of intraoperative blood loss. Our data suggest that patients with these types of spine metastases might not benefit from PE. Larger studies could aid in finding a subset of spine metastases that may benefit from PE. <h3>FDA DEVICE/DRUG STATUS</h3> This abstract does not discuss or include any applicable devices or drugs.