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Neurointerventional Surgery

Pre-Operative Tumor Embolization: Spine

What is pre-operative tumor embolization?

Pre-operative tumor embolization is a treatment that can be applied to a wide variety of tumors, the most common of which is meningioma. A meningioma is classically a benign-type of tumor that grows from the tissue lining the brain. Depending on a variety of factors, it may be necessary to surgically remove these tumors. However, they often have a robust blood supply arising from the vessels of the lining of the brain. The goal of pre-operative embolization is to block off the blood supply to a tumor in order to make surgical removal safer with a significant reduction in intraoperative blood loss.

This same treatment can be applied to a wide variety of tumors of the head, neck, and spine. In tumors of the neck, the tumor may sometimes be directly accessed with a needle and embolized. We most often use particulate embolics in these cases.

By navigating a microcatheter into the vessels supplying the tumor, we can inject tiny particles that block the blood flow. In certain cases, such as in the direct needle access technique described above, we may inject a glue-like material known as Onyx which similarly fills up the blood vessels of the tumor and improves the safety of surgical removal.

As tumor location and blood supply dictate the risk/benefit ratio for any given case, a detailed discussion is necessary prior to proceeding. In-depth knowledge of head, neck, and spinal vascular anatomy is required to avoid damage to important structures, including the eye and cranial nerves of the head and neck, spinal cord, or skin damage or discoloration.