Intraarterial Ethanol Embolization as a Palliative Treatment for Metastatic Lesions of the Spine

Purpose The management of malignant spine lesions has had a controversial course. Though many reasons exist to aggressively treat such lesions, the most common reason to pursue therapy has been to control neuropathic pain syndromes in an attempt to improve quality of life. Whereas aggressive attempts at resection are usually not pursued, surgeons have locally debulked such lesions around nerve roots in order to decompress affected nerve roots and provide temporary relief of pain. Other techniques such as implantable spinal stimulators, pumps, dorsal root entry zone radio-ablation procedures (DREZ) and even cordotomies have been used with variable success. We report our experience with use of selective endovascular ethanol embolization of malignant spine tumors for management of severe neuropathic pain.