Interventional Radiology in Primary Spinal Tumors

Primary tumors of the spinal axis are rare, with the majority being benign in nature. Most are asymptomatic and are often found incidentally on imaging. For these, conservative management may be all that is required, with or without the potential need for clinical and/or imaging follow-up. However, some may warrant active management, such as if the spinal tumor is malignant, or if there is concern of local complications, such as neural compromise, or in the setting of pain or other symptoms, regardless of histology. Although surgery remains an important treatment option, especially in the management of primary spinal malignancy, advances in interventional radiology techniques have expanded the role for minimally invasive image-guided approaches, whether it be to assist surgery or as independent curative or symptom-based management strategies. Indeed, these advances now allow for more primary spinal tumors to be treated, with many benign tumors no longer requiring surgical intervention. The role of interventional radiology in the diagnosis and management of primary spinal tumors will be discussed, including percutaneous and endovascular techniques, with case examples highlighting some of these options.