Transarterial chemoembolization for pain relief in patients with hypervascular painful metastatic spinal tumors refractory to percutaneous vertebroplasty

Purpose This study is aimed at evaluating the safety and efficacy of transarterial chemoembolization (TACE) for patients with hypervascular painful metastatic spinal tumors refractory to percutaneous vertebroplasty (PVP). Methods A total of 11 patients with hypervascular painful metastatic spinal tumors refractory to PVP were recruited for testing the safety and efficacy of TACE. Individual patients were subjected to infusion with 40 mg/m 2 epirubicin and 20–60 mg polyvinyl alcohol foam (PVA) particles (300–500 μm) or gel-foam strips for embolization through the dominant arteries to the tumor. The degrees of pain the patients suffered were evaluated using the visual analogue scale (VAS) score one day before, 5 days, and 2 weeks after TACE. The neurologic symptoms and skin/muscle complications were observed. Results A total of 12 lumbar vertebrae from 11 patients were treated with TACE through 21 vertebral arteries. Twelve out of 21 arteries were embolized with PVA particles, and other nine arteries were embolized with gel-foam strips. The analgesic rate of TACE in those patients was 90.9 % at 5 and 14 days postprocedure. The VAS scores in those patients were reduced from preoperative 8.6 ± 1.1 to 3.9 ± 1.38 on day 5 and to 3.6 ± 1.7 at 2 weeks post-TACE, respectively. There was no obvious neurologic symptom or skin/muscle necrosis in those patients. Conclusions Transarterial chemoembolization (TACE) is a safe and effective therapy for pain relief in patients with hypervascular painful metastatic spinal tumors refractory to PVP.