Endovascular embolization with Onyx of spinal metastases from renal cell carcinoma

Bone metastases occur in 50% of patients with renal cell carcinoma, approximately 15% of these occur in the spine. In patients with disseminated disease with osseous metastases in vertebral bodies without options for curative treatment, cement injection in the vertebrae can be a useful tool in the management of pathologic fractures by allowing stabilization of the spine and ameliorating pain.

A potential contraindication to this procedure is posterior vertebral wall involvement due to increased risk of cement leakage into the epidural space. In some of these cases, embolization with PVA particles and/or surgery is necessary.

We present a case of lumbar spine metastases from renal cell carcinoma, with posterior wall involvement, that was treated by endovascular embolization using Onyx polymer. To the best of our knowledge, embolization of this kind of lesion, using this embolic agent, has not been previously reported.