脊柱转移通常会引起明显的疼痛、不稳定以及/或神经病变。系统治疗、放射疗法和手术技术的进展增加了对脊柱转移的局部控制(LC)。先前的报告表明，术前动脉栓塞与LC和姑息性疼痛控制的改善有关。为进一步阐明新辅助栓塞对脊柱转移的LC和接受手术和立体定向体放射治疗（SBRT）的患者的疼痛控制潜力的作用，对2012年至2020年单个中心进行回顾性研究，共发现117名患有各种实体肿瘤的脊柱转移患者进行手术治疗和辅助 SBRT，或术前脊柱动脉栓塞加手术和SBRT治疗。复查人口统计学信息、影像学研究、治疗特征、Karnofsky绩效评分、防御性退伍军人疼痛评分量表和镇痛药物的平均日剂量。将LC定义为手术治疗的椎骨水平的进展，并使用中位3个月间隔获取的磁共振成像进行评估。在117名患者中，47名（40.2％）进行了术前栓塞治疗，接着进行手术和SBRT，而70名（59.8％）只接受了手术和SBRT治疗。在栓塞组中，中位LC为14.2个月，而非栓塞组为6.3个月（P = .0434）。接受栓塞的患者占比≥82.5％意味着有显著改善LC的预测（曲线下面积=0.808；P < .0001）。防御性退伍军人疼痛评分量表的平均分和最高分在栓塞后立即显著降低（P < .001）。术前栓塞与LC和疼痛控制的改善有关，这表明了其使用的新颖作用。需要进行更多的前瞻性研究。版权所有©2023年神经外科医师大会。保留所有权利。

Spine metastases often cause significant pain, instability, and/or neurological morbidity. Local control (LC) of spine metastases has been augmented with advances in systemic therapies, radiation, and surgical technique. Prior reports suggest an association between preoperative arterial embolization and improved LC and palliative pain control.To further elucidate the role of neoadjuvant embolization on LC of spine metastases and the potential for improved pain control in patients receiving surgery and stereotactic body radiotherapy (SBRT).A retrospective single-center review between 2012 and 2020 identified 117 patients with spinal metastases from various solid tumor malignancies managed with surgery and adjuvant SBRT with or without preoperative spinal arterial embolization. Demographic information, radiographic studies, treatment characteristics, Karnofsky Performance Score, Defensive Veterans Pain Rating Scale, and mean daily doses of analgesic medications were reviewed. LC was assessed using magnetic resonance imaging obtained at a median 3-month interval and defined as progression at the surgically treated vertebral level.Of 117 patients, 47 (40.2%) underwent preoperative embolization, followed by surgery and SBRT and 70 (59.8%) underwent surgery and SBRT alone. Within the embolization cohort, the median LC was 14.2 months compared with 6.3 months among the nonembolization cohort (P = .0434). Receiver operating characteristic analysis suggests ≥82.5% embolization predicted significantly improved LC (area under the curve = 0.808; P < .0001). Defensive Veterans Pain Rating Scale mean and maximum scores significantly decreased immediately after embolization (P < .001).Preoperative embolization was associated with improved LC and pain control suggesting a novel role for its use. Additional prospective study is warranted.Copyright © Congress of Neurological Surgeons 2023. All rights reserved.