{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T22:54:35Z","timestamp":1793746475206,"version":"4.6.1"},"reference-count":36,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2024,4,22]],"date-time":"2024-04-22T00:00:00Z","timestamp":1713744000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Interv Neuroradiol"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Onyx embolization has emerged as a promising technique for spinal tumor embolization due to its high devascularization rate and low incidence of complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Evaluate the safety and efficacy of Onyx embolization in spinal tumor procedures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Following the PRISMA guidelines, we conducted a systematic review and meta-analysis. To be included, the articles had to report specific outcomes of Onyx embolization for spinal tumors (complications, mortality, blood loss, tumor devascularization, or reduction in tumor blush).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We selected 11 out of 2941 articles, encompassing 127 patients. Among them, no major complications or persistent neurological deficits were reported, and no deaths occurred as a result of the embolization procedure. Of the 63 patients with available data, two complications were observed: one infarct leading to transient neurological deficit and one clinically silent vessel perforation related to the microcatheter. Thus, the complication rate was 1% (95% confidence interval (CI): 0% to 6%). Blood loss during surgery ranged from 100 to 1500\u2005mL (four studies). Complete tumor blush reduction was achieved in 52% of the cases (95% CI: 16% to 88%) across 32 patients. Three studies reported a median percentage of tumor devascularization of 91% (86.1% to 97.5%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Onyx embolization for spinal tumor procedures appears to be a safe technique, as evidenced by the absence of major complications or deaths. However, the determination of its efficacy remains challenging due to limited data availability and substantial heterogeneity across studies. These findings highlight the need for future research to address this knowledge gap and further validate our results.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15910199241227990","type":"journal-article","created":{"date-parts":[[2024,4,22]],"date-time":"2024-04-22T03:58:35Z","timestamp":1713758315000},"page":"1660-1668","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":6,"title":["Spinal tumor embolization with Onyx: A systematic review and meta-analysis"],"prefix":"10.1177","volume":"32","author":[{"given":"Savio","family":"Batista","sequence":"first","affiliation":[{"name":"Federal University of Rio de Janeiro"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filipi","family":"Fim Andre\u00e3o","sequence":"additional","affiliation":[{"name":"Federal University of Rio de Janeiro"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcelo Porto","family":"Sousa","sequence":"additional","affiliation":[{"name":"Federal University of Rio de Janeiro"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-5612-556X","authenticated-orcid":false,"given":"Leonardo de Barros","family":"Oliveira","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, State University of Ponta Grossa, Ponta Grossa, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucca Biolcati","family":"Palavani","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Max Planck University Center, Indaiatuba, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guilherme","family":"Melo Silva","sequence":"additional","affiliation":[{"name":"Federal University of Rio de Janeiro"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-5704-8571","authenticated-orcid":false,"given":"Livia V","family":"de Abreu","sequence":"additional","affiliation":[{"name":"Federal University of Rio de Janeiro"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raphael","family":"Bertani","sequence":"additional","affiliation":[{"name":"University of Sao Paulo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danilo","family":"Gomes Quadros","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, N\u00facleo Oscar Freire, Salvador, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,4,22]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1136\/neurintsurg-2014-011505"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clineuro.2013.09.033"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.21037\/jss.2018.09.02"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1136\/neurintsurg-2015-011833"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.7461\/jcen.2013.15.4.320"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1136\/neurintsurg-2012-010542"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0034-1394191"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1227\/NEU.0b013e3182648db6"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.3171\/2013.3.SPINE12832"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.3171\/2009.7.JNS09351"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1227\/01.NEU.0000315300.83459.5C"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A1010"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.otsr.2012.03.008"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.3171\/spi.2003.98.2.0156"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.3109\/17453679308994517"},{"key":"e_1_3_2_17_2","first-page":"997","article-title":"Spinal metastases from renal cell carcinoma: effect of preoperative particle embolization on intraoperative blood loss","volume":"22","author":"Manke C","year":"2001","unstructured":"Manke C, Bretschneider T, Lenhart M, et al. 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