Neurologic Complications of Preoperative Embolization of Spinal Metastasis: A Systemic Review of the Literature Identifying Distinct Mechanisms of Injury

Houten, John K.; Swiggett, Samuel J.; Hadid, Bana; Choueka, David M.; Kinon, Merritt D.; Buciuc, Razvan; Zumofen, Daniel

doi:10.1016/j.wneu.2020.08.006

Cited by 17 publications

(24 citation statements)

References 73 publications

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“…Spinal artery air embolism is also a rare complication; so far, only one case has been reported (12). It mainly manifests as nerve damage symptoms due to spinal cord ischemic infarction, including paraplegia and motor and sensory disturbances (13). In this case, the spinal artery air embolism occurred in the left spinal artery at the eighth thoracic vertebra level, which may be related to the loss of muscle strength in the lower limbs.…”

Section: Discussionmentioning

confidence: 77%

Underestimated pulmonary hemorrhage—a fatal complication combined with systemic air embolism after CT-guided lung biopsy: a case description

Fang¹,

Li²,

Sun³

et al. 2021

Quant Imaging Med Surg

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Section: Discussionmentioning

confidence: 77%

Underestimated pulmonary hemorrhage—a fatal complication combined with systemic air embolism after CT-guided lung biopsy: a case description

Fang¹,

Li²,

Sun³

et al. 2021

Quant Imaging Med Surg

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“…In this context, the decision to apply preoperative embolization has to be made on an individual basis until larger prospective studies have been conducted. 26,28,29,33,34 In addition to known factors, such as the operative time and type of surgery, we investigated the usefulness of the routinely acquired preoperative ASA and MET scores. Although subjective, the ASA score is usually a good independent prognostic factor for perioperative morbidity.…”

Section: Discussionmentioning

confidence: 99%

Intraoperative blood loss in oncological spine surgery

Mohme¹,

Mende²,

Pantel³

et al. 2021

Neurosurgical Focus

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OBJECTIVE Intraoperative blood loss in patients undergoing oncological spine surgery poses a major challenge for vulnerable patients. The goal of this study was to assess how the surgical procedure, tumor type, and tumor anatomy, as well as anesthesiological parameters, affect intraoperative blood loss in oncological spine surgery and to use this information to generate a short preoperative checklist for spine surgeons and anesthesiologists to identify patients at risk for increased intraoperative blood loss. METHODS The authors performed a retrospective analysis of 430 oncological patients who underwent spine surgery between 2013 and 2018 at the university medical spine center. Enrolled patients had metastatic tumor of the spine requiring surgical decompression of neural structures and/or stabilization including tumor biopsy using an open, percutaneous, and/or combined dorsoventral approach. Patients requiring vertebro- and kyphoplasty or biopsy only were excluded. Statistical analyses performed included a multiple linear regression analysis. RESULTS The mean intraoperative blood loss in the study patient cohort was 1176 ± 1209 ml. In total, 33.8% of patients received intraoperative red blood cell transfusions. The statistical analyses showed that tumor histology indicating myeloma, operative procedure length, epidural spinal cord compression (ESCC) score, tumor localization, BMI, and surgical strategy were significantly associated with increased intraoperative blood loss or risk of needing allogeneic blood transfusions. Anesthesiological parameters such as the American Society of Anesthesiologists (ASA) Physical Status classification score were not associated with blood loss. Multiple linear regression analysis demonstrated good predictive value (r = 0.437) for a five-item preoperative checklist to identify patients at risk for high intraoperative blood loss. CONCLUSIONS The analyses performed in this study demonstrated key factors affecting intraoperative blood loss and showed that a simple preoperative checklist including these factors can be used to identify patients undergoing surgery for metastatic spine tumors who are at risk for increased intraoperative blood loss.

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“…Terdapat banyak informasi yang dapat diperoleh dari berbagai kasus yang disajikan dalam penelitan ini, seperti keuntungan maupun kerugian embolisasi, komplikasi, bahan embolan, timing embolisasi, dan lainnya. [10][11][12][13][14][15][16] Pada era modern dewasa ini, para tenaga kesehatan dituntut untuk memaksimalkan fasilitas yang ada dengan tujuan mengurangi morbiditas pasien, salah satunya yaitu memaksimalkan tindakan minimal invasif seperti embolisasi preoperatif yang dapat mengurangi perdarahan intraoperatif pada tulang belakang. Seiring berjalannya waktu, embolisasi preoperatif telah dikembangkan untuk mengurangi jumlah perdarahan pada operasi dekompresi tulang belakang.…”

Section: Pendahuluanunclassified

“…Semua penelitian yang dikaji memberikan informasi tentang teknik dan pendekatan yang sama. [10][11][12][13][14][15][16] Hal yang berbeda ialah bahan embolan yang digunakan. Coiling paling sering digunakan karena aman dan jarang terjadi perpindahan coiling ke tempat lain yang tidak diinginkan, disusul oleh onyx®(Medtronic), embosphere, dan PVA.…”

Section: Bahasanunclassified

“…Tuchmann et al 10 menggunakan PVA tetapi pada penelitian tersebut PVA tidak dapat menyumbat pembuluh darah secara total yang akhirnya dikombinasikan dengan gel foam, sedangkan Tomura et al 12 dan Matsumoto et al 13 menggunakan coiling pada penelitiannya dan tidak mendapatkan komplikasi pasca embolisasi. Pada penelitian Torron-Fernandez et al 14 dan Houten et al 15 digunakan materi embosphere dengan dosis yang bervariasi dan komplikasi yang didapatkan saat menggunakan embosphere yaitu Brown Sequard Syndrome serta salah satu embosphere pecah dan berpindah ke fossa posterior kepala yang mengakibatkan kelumpuhan sementara. Pada penggunaan bahan onyx® (Medtronic), coiling, maupun PVA tidak ditemukan komplikasi.…”

Section: Bahasanunclassified

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Embolisasi Preoperatif pada Operasi Dekompresi Tulang Belakang

Pali

Prasetyo

Suharso

et al. 2021

eCL

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Embolization is an effective way of controlling bleeding. This study was aimed to provide some information about preoperative spinal embolization, embolization materials, and complications. This was a literature review study using an online journal database and Google Scholar. The keywords used were Preoperative Spinal Embolization. The feasibility of the selected studies were case reports. The results showed that all studies used the same technique and approach to achieve different goals. The difference among them was the choice of embolan material. The complications that arose were few and could be managed. In conclusion, preoperative spinal embolization is the choice of therapy that give more benefit and safety.Keywords: preoperative spinal embolization; spinal decompression surgery; embolan Abstrak: Embolisasi merupakan cara yang efektif dalam mengontrol perdarahan. Penelitian ini bertujuan memberikan informasi mengenai embolisasi tulang belakang, bahan embolan, dan komplikasi yang ditimbulkan. Jenis penelitian ialah suatu literature review menggunakan database jurnal online dan Google Scholar. Pencarian data menggunakan kata kunci Preoperative Spinal Embolization. Kelayakan penelitian yang dipilih bersifat case report. Hasil penelitian mendapatkan bahwa semua penelitian menggunakan teknik dan pendekatan yang sama untuk mencapai tujuan yang berbeda. Perbedaannya ialah dalam hal pemilihan bahan embolan. Komplikasi yang terjadi hanya sedikit dan dapat diatasi. Simpulan penelitian ini ialah preoperative spinal embolization merupakan terapi pilihan yang menguntungkan dan aman.Kata kunci: embolisasi preoperatif; operasi dekompresi tulang belakang; embolan

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Neurologic Complications of Preoperative Embolization of Spinal Metastasis: A Systemic Review of the Literature Identifying Distinct Mechanisms of Injury

Cited by 17 publications

References 73 publications

Underestimated pulmonary hemorrhage—a fatal complication combined with systemic air embolism after CT-guided lung biopsy: a case description

Underestimated pulmonary hemorrhage—a fatal complication combined with systemic air embolism after CT-guided lung biopsy: a case description

Intraoperative blood loss in oncological spine surgery

Embolisasi Preoperatif pada Operasi Dekompresi Tulang Belakang

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