Preoperative Embolization of Spinal Tumor Using Obsidio Conformable Embolic in a Case Report

Introduction Metastatic spinal tumors frequently cause severe pain and neurologic decline due to cord compression. Preoperative embolization of hypervascular lesions, especially those from clear cell renal cell carcinoma (ccRCC), reduces intraoperative blood loss and improves surgical visibility. Obsidio Conformable Embolic (OCE) is a shear‐thinning embolic agent FDA‐approved for peripheral use, but its role in neurovascular or spinal applications has not been previously described. We report the first documented case of OCE use for preoperative embolization of a spinal metastasis. Methods We reviewed the clinical course of a patient in their 70s with metastatic ccRCC with severe back and chest pain. Imaging demonstrated a T5 vertebral body metastasis with spinal cord compression (Figure 1). Preoperative embolization was performed via femoral arterial access, targeting segmental arteries T4‐T6. Embolization was achieved using Embosphere particles followed by delivery of Obsidio Conformable Embolic (OCE) (Figure 2). Angiographic outcomes, intraoperative blood loss, and postoperative course were documented. Results All target vessels (T4‐T6 segmental arteries) were successfully occluded, with angiography confirming complete embolization and excellent radiopacity of OCE. The material demonstrated high conformability and allowed repeated injections through a single catheter without entrapment. The following day, the patient underwent laminectomy, tumor excision, and spinal fusion with estimated intraoperative blood loss of 500 mL. Postoperatively, the patient developed neurological complications attributed to persistent spinal compression and hematoma rather than the embolization technique. No procedure‐related vascular complications were observed. Conclusion This case demonstrates the feasibility of OCE for embolization of a hypervascular spinal metastasis, highlighting its potential advantages of conformability, durable vessel occlusion, and reduced risk of non‐target embolization in complex anatomy. While embolization remains a critical adjunct in managing hypervascular spinal tumors, further studies are needed to establish the safety, efficacy, and role of OCE in spinal and neurovascular interventions.