Background: By observing the change characteristics of NLR at different stages after operation, to make a preliminary analysis of the effect of operation on the immune status of MM patients and study the prognostic value of peripheral blood NLR in predicting the treatment of multiple myeloma bone disease (MMBD).Method: The clinical data of 82 MMBD patients who underwent operations in our hospital were collected, which to analyze the effect of preoperative peripheral blood NLR on the prognosis of MMBD patients; Peripheral blood lymphocyte percentage was taken as the major observation indicator to analyze the change characteristics of the immune status of MM patients.Results: Data showed that the NLR cut-off values of the NLR≥3 group and NLR≥4 group were significantly correlated with POS. The POS of NLR≥3 patients (14.86±14.28) was significantly shorter than that of NLR＜3 patients (32.68±21.76). The lymphocyte percentage 1 week after operation (19.329±9.083) was significantly lower than that before operation (25.723±11.016). Survival analysis showed that postoperative chemotherapy and preoperative peripheral blood NLR were independent risk factors for POS.Conclusions: NLR was significant for the prediction of the POS of MMBD patients treated with operation, and MMBD patients with high preoperative NLR (NLR≥3) had a poorer prognosis and shorter POS. The immune status of MMBD patients was at a normal low level, and significantly declined after operation.Trial registration: The conducted study contains a retrospective analysis of medical records of our hospital database. Beijing Chao-yang Hospital Human Research Ethics Committee classifies this as a retrospective audit. The ethics approval and consent was given for the conducted retrospective data analysis.

Background A spinal stability scoring system for multiple myeloma (MM) was established via evidence-based literature and expert advice, and it was used to evaluate spinal stability in multiple myeloma patients. Methods The Delphi method was used to establish an expert consensus and establish a spinal stability scoring system for multiple myeloma. The clinical data of 72 patients with multiple myeloma with spinal involvement in our hospital were retrospectively reviewed. Results The grading system included 6 first-level indicators and 29 second-class indicators; the 6 first-level indicators were the following: the position of the spinal lesions, the degree of pain, the number of segments involved in the spinal lesions, the changes in the spinal images, the complications and the neurological function. After weighting the significance of the indicators, the highest total score possible was 24; a score of 0–10 corresponded to stable, 11–17 corresponded to potentially unstable, and 18–24 corresponded to unstable. Conclusion The scoring system, which is based on the disease characteristics, typical symptoms and spinal imaging manifestations in multiple myeloma patients, can be used to guide clinicians in evaluating the spinal stability of MM patients and determining the spinal instability caused by multiple myeloma over time, thereby providing evidence for MM patients to choose protective interventions. Trial registration: As this was a retrospective study, it did not require ethical approval.

Background: Multiple myeloma is an incurable malignant plasma cell disorder that represents the most common primary malignant bone tumor. It commonly involves bone metastasis in multiple vertebral bodies, which SINS scoring system may not be fully applicable to MM patients. We designed a stability evaluation system to evaluate the spinal stability of patients with MM spinal involvement in order to guide clinical treatment. Methods: By using Delphi method, information was collected and extracted through a series of questionnaires and improved via feedback and we preliminary establishment of a spinal stability scoring system for multiple myeloma. Results: Fifteen clinicians completed a second round of questionnaires and compared their answers with those of the first round of questionnaires to identify significant comments or changes that required group discussions. As a result, no further feedback was used to improve the scoring system. After integrating the information from the expert consultation questionnaire, we established the initial scoring system for MM spine stability and used the scoring system to assess a series of representative clinical cases. The scoring system consisted of the following six components.The MM spinal stability scoring system was created by calculating the scores of the six separate components: Location, Pain, Number of segments, Physiological curvature, Comorbidities and Neurological function. The minimum value was ‘0’, and the maximum value was ‘24’. A score of ‘0-10’ indicated ‘spine stability’, a score of ‘11-17’ indicated ‘potential instability’, and a score of ‘18-24’ indicated ‘spine instability’. Patients with a score of ‘11-24’ need an intervention such as surgery. Conclusions: The initial establishment of the MM spine stability scoring system provides a vital theoretical basis for the evaluation of spine stability in individuals with MM. Trial registration: The conducted study contains a retrospective analysis of medical records of our hospital database. Beijing Chao-yang Hospital Human Research Ethics Committee classifies this as a retrospective audit. The ethics approval and consent was given for the conducted retrospective data analysis.

Background: The phenomenon of spontaneous resorption of a herniated disc (HD) is a common occurrence. In literature, there are many studies attempting to explain the mechanism for regression, including imaging techniques and immunohistologic analyses. Nevertheless, the exact mechanism remains uncertain. In addition, the connection between HD regression and general conditions of patients is not concerned yet. Here we report a case of spontaneous resorption of a lumbar disc herniation in a patient with multiple myeloma, which had not reported before.Case presentation: An illustrative patient, a 42-year-old Chinese man, was admitted to our hospital with a disc herniation at L5-S1, experiencing 2-months history of low back pain and 1-month left leg pain. He was treated conservatively with medication and physical therapy. Then he was symptom-free after 2 months. The low back pain of the patient recurred with the herniated lumbar disc disappearing after 2 years. The disappearance demonstrated by magnetic resonance imaging (MRI). And besides, the patient was diagnosed with multiple myeloma (MM). The emergence of MM might result in the recurred backache, and the process of HD resorption might be accelerated by the high serum Vascular endothelial growth factor (VEGF) of the MM patient.Conclusions: For patients who suffering from intervertebral disc herniation together with diseases upregulating VEGF level, such as MM, surgical treatment should be limited and the conservatively treating time can be lengthened.

Background: Multiple myeloma (MM) is an incurable malignant plasma cell disorder that represents the most common primary malignant bone tumor. It commonly involves bone metastasis in multiple vertebral bodies, which SINS scoring system may not be fully applicable to MM patients. We designed a stability evaluation system to evaluate the spinal stability of patients with MM spinal involvement in order to guide clinical treatment. Methods: By using Delphi method, information was collected and extracted through a series of questionnaires and improved via feedback and we preliminary establishment of a spinal stability scoring system for multiple myeloma. Results: Fifteen clinicians completed a second round of questionnaires and compared their answers with those of the first round of questionnaires to identify significant comments or changes that required group discussions. As a result, no further feedback was used to improve the scoring system. After integrating the information from the expert consultation questionnaire, we established the initial scoring system for MM spine stability and used the scoring system to assess a series of representative clinical cases. The scoring system consisted of the following six components.The MM spinal stability scoring system was created by calculating the scores of the six separate components: Location, Pain, Number of segments, Physiological curvature, Comorbidities and Neurological function. The minimum value was ‘0’, and the maximum value was ‘24’. A score of ‘0-10’ indicated ‘spine stability’, a score of ‘11-17’ indicated ‘potential instability’, and a score of ‘18-24’ indicated ‘spine instability’. Patients with a score of ‘11-24’ need an intervention such as surgery. Conclusions: The initial establishment of the MM spine stability scoring system provides a vital theoretical basis for the evaluation of spine stability in individuals with MM. Trial registration: As this was a retrospective study, it did not require ethical approval; all patients had signed informed consent when they received treatment, and all treatment options were voluntary.