Effect of preoperative embolization of spinal metastases on intraoperative blood loss

Background This study provides a detailed evaluation of the effect preoperative embolization of spinal metastases has on reducing intraoperative blood loss (IBL) and the need for transfusion of packed red blood cells.Methods A systematic search for all articles on the topic of preoperative embolization of spinal metastases was performed. Data for estimated intraoperative blood loss and transfusion units from eligible studies were extracted. A threshold of P < 0.05 was established to indicate the contribution of significant heterogeneity to the pooled effect size.Results The total number of patients from the 15 included articles totaled 1287. The standardized mean difference attributable to preoperative embolization for the volume of IBL was −0.396 (95% confidence interval [CI]: −0.769 to −0.022, tau2 = 0.351, tau = 0.593, I2 = 81.88% [CI: 63.0% to 85.7%], P < 0.04). The standardized mean difference attributable to preoperative embolization for transfusion units was 0.120 (95% CI: −0.375 to 0.615, tau2 = 0.093, tau = 0.306, I2 = 66.89% [CI: 23.6% to 84.8%], P = 0.54).Conclusion Preoperative embolization of spinal metastases is effective in decreasing IBL volume but had no significant effect on the quantity of transfused units of packed red blood cells.