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J Natl Med Assoc. Oct 2006; 98(10): 1654–1658.
PMCID: PMC2569744

Functional results of vertebral augmentation techniques in pathological vertebral fractures of myelomatous patients.

Abstract

INTRODUCTION: This is a retrospective study to determine the effects of vertebroplasty and kyphoplasty on quality of life in multiple myeloma patients with spinal compression fractures. MATERIAL AND METHODS: Thirty-four patients with primary multiple myeloma were treated for symptomatic compression fractures between June 2003 and June 2005. Kyphoplasty was applied to 22 levels in 18 and vertebroplasty to 28 levels in 16 patients. The pain-related disability was evaluated for every single daily living activity using visual analog scale (VAS) over 10 points. (pain at rest, walking, sitting-standing, taking a shower and wearing clothes). (This evaluation is performed to every patient with degenerative disorders of the spine upon admission to our clinic.) Overall VAS scores were evaluated over 50 points (0 minimum, 50 maximum) preoperatively, at postoperative six weeks, six months and at one year prior to taking analgesics. The amount of analgesic use was recorded. Data was analyzed statistically using variance analysis, Friedman's multiple comparison test and Student's t test. RESULTS: The mean overall pain score in the kyphoplasty group decreased from a preoperative value of 36 to 12.13 at the sixth postoperative week, to 8.63 at the sixth month and to 9.72 at one year. (p<0.001). The mean overall pain score in the vertebroplasty group decreased from a preoperative value of 37.83 to 15.33 at the sixth postoperative week, to 12.17 at sixth months and to 13.47 at one year. (p<0.001). Student's t test was used to analyze the percentage of differences in overall pain score. Difference between groups was not statistically significant at the sixth week (p=0.106) but was statistically significant both at the sixth month (p=0.024) and at one year (p=0.027) in favor of kyphoplasty group. No secondary collapse was observed in adjacent levels in both groups. There were no intrapostoperative neurologic/pulmonary complications in both groups. Analgesics usage significantly decreased in both groups. CONCLUSION: In multiple myeloma, when pathological spinal compression fractures cause intractable pain and are unresponsive to conservative treatment, both vertebroplasty and kyphoplasty are effective in increasing quality of life and decreasing pain.

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  • Kyle Robert A, Gertz Morie A, Witzig Thomas E, Lust John A, Lacy Martha Q, Dispenzieri Angela, Fonseca Rafael, Rajkumar S Vincent, Offord Janice R, Larson Dirk R, et al. Review of 1027 patients with newly diagnosed multiple myeloma. Mayo Clin Proc. 2003 Jan;78(1):21–33. [PubMed]
  • Kumar Ambuj, Loughran Thomas, Alsina Melissa, Durie Brian G M, Djulbegovic Benjamin. Management of multiple myeloma: a systematic review and critical appraisal of published studies. Lancet Oncol. 2003 May;4(5):293–304. [PubMed]
  • Anderson Kenneth C. Multiple myeloma: how far have we come? Mayo Clin Proc. 2003 Jan;78(1):15–17. [PubMed]
  • Coen Diane. Kyphoplasty as a treatment for vertebral compression fractures as a result of multiple myeloma. Clin J Oncol Nurs. 2003 Mar-Apr;7(2):236–237. [PubMed]
  • Dudeney S, Lieberman IH, Reinhardt M-K, Hussein M. Kyphoplasty in the treatment of osteolytic vertebral compression fractures as a result of multiple myeloma. J Clin Oncol. 2002 May 1;20(9):2382–2387. [PubMed]
  • Croucher PI, Apperley JF. Bone disease in multiple myeloma. Br J Haematol. 1998 Dec;103(4):902–910. [PubMed]
  • Diamond Terrence H, Hartwell Tabitha, Clarke William, Manoharan Arumugam. Percutaneous vertebroplasty for acute vertebral body fracture and deformity in multiple myeloma: a short report. Br J Haematol. 2004 Feb;124(4):485–487. [PubMed]
  • Barr JD, Barr MS, Lemley TJ, McCann RM. Percutaneous vertebroplasty for pain relief and spinal stabilization. Spine (Phila Pa 1976) 2000 Apr 15;25(8):923–928. [PubMed]
  • Yamaura Ichiro, Yone Kazunori, Nakahara Shinji, Nagamine Tomonori, Baba Hisatoshi, Uchida Kenzo, Komiya Setsuro. Mechanism of destructive pathologic changes in the spinal cord under chronic mechanical compression. Spine (Phila Pa 1976) 2002 Jan 1;27(1):21–26. [PubMed]
  • Jensen ME, Evans AJ, Mathis JM, Kallmes DF, Cloft HJ, Dion JE. Percutaneous polymethylmethacrylate vertebroplasty in the treatment of osteoporotic vertebral body compression fractures: technical aspects. AJNR Am J Neuroradiol. 1997 Nov-Dec;18(10):1897–1904. [PubMed]
  • Deramond H, Depriester C, Galibert P, Le Gars D. Percutaneous vertebroplasty with polymethylmethacrylate. Technique, indications, and results. Radiol Clin North Am. 1998 May;36(3):533–546. [PubMed]
  • Cotten A, Boutry N, Cortet B, Assaker R, Demondion X, Leblond D, Chastanet P, Duquesnoy B, Deramond H. Percutaneous vertebroplasty: state of the art. Radiographics. 1998 Mar-Apr;18(2):311–323. [PubMed]
  • Quinn JM, Morfis M, Lam MH, Elliott J, Kartsogiannis V, Williams ED, Gillespie MT, Martin TJ, Sexton PM. Calcitonin receptor antibodies in the identification of osteoclasts. Bone. 1999 Jul;25(1):1–8. [PubMed]
  • Lane Joseph M, Hong Richard, Koob Jason, Kiechle Tamara, Niesvizky Ruben, Pearse Roger, Siegel David, Poynton Ashley R. Kyphoplasty enhances function and structural alignment in multiple myeloma. Clin Orthop Relat Res. 2004 Sep;(426):49–53. [PubMed]

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