Objective: Multiple myeloma (MM) is a neoplasm characterized by the proliferation of somatically mutated plasma cells that tend to expand within the bone marrow and affect multiple locations throughout the bone marrow. When it is located in vertebral areas it causes bone lesions with pain, kyphosis, walking impairments, and disability. Different types of treatments are available. The goal of this study is to report our experience regarding the treatment of vertebral fractures from multiple myeloma using cementoplasty.
Patients and Methods: From January 2012 to December 2015, 38 patients with multiple myeloma and multilevel vertebral fractures were treated. Seventeen patients underwent conservative treatment (group 1), and 21 patients underwent vertebral augmentation with percutaneous cementoplasty (group 2). Both groups were clinically evaluated at 1, 6 and 12 months using a visual analogic scale (VAS) for pain, SF-36 and ODI Score Questionnaires. Radiographic evaluation was performed to verify the quality of cementoplasty and complications.
Results: Mean follow-up was 23.7 months. Mean VAS score in group 1 decreased from 7.1 pre-operatively to 3.9 at final follow-up (p<0.05). In group 2, this score decreased from 7.3 pre-operatively to 2.3 at final follow-up (p<0.05). Mean SF-36 values in group 1 increased from 34.1 pre-operatively to 58.6 at final follow-up (p<0.05), while in group 2 increased from 31.5 pre-operatively to 76.9 at final follow-up (p<0.05). Mean ODI score in group 1 decreased from 73.3 pre-operatively to 44.9 at final follow-up (p<0.05), while in group 2 decreased from 77.5 pre-operatively to 23.1 at final follow-up (p<0.05). Complications were seen in one (4.8%) case of cement leakage.
Conclusions: Our study shows that cementoplasty is a safe and effective option to treat vertebral lesions in patients with multiple myeloma.