Surgery for plasma cell neoplasia patients with spinal instability or neurological impairment caused by spinal lesions as the first clinical manifestation

Cai, Weiluo; Yan, Wangjun; Huang, Quan; Huang, Wending; Yin, Huabin; Xiao, Jianru

doi:10.1007/s00586-014-3679-y

Cited by 13 publications

(12 citation statements)

References 19 publications

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“…Previous studies [14–16] speculated that chemotherapy or radiotherapy alone could achieve the corresponding treatment effect. Strikingly, Cai [17] reviewed 30 MM patients with spinal metastasis undergone internal fixation, and the pain and neurological function of the patients were found to be improved post-surgery. The study postulated that internal fixation was efficient in the treatment of MM patients with spinal instability and neurological dysfunction.…”

Section: Discussionmentioning

confidence: 99%

PKP/PVP combine chemotherapy in the treatment of multiple myeloma patients with vertebral pathological fractures: minimum 3-year follow-up of 108 cases

Yao

2019

J Orthop Surg Res

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BackgroundMultiple myeloma (MM) is a blood system malignant tumor, which often leads to osteolytic bone destruction, and the vertebral column is the primary site of involvement. However, the efficacy and prognosis of percutaneous kyphoplasty/vertebroplasty (PKP/PVP) for simple vertebral pathological fractures in patients with multiple myeloma are not yet unified. The primary objective of this study was to investigate the efficacy and prognosis of PKP/PVP in the treatment of multiple myeloma patients with vertebral pathological fractures.MethodsA total of 108 patients with MM from Beijing Chao-Yang Hospital from 2007 to 2013 were enrolled. Of these, 52 patients underwent PKP/PVP surgery and chemotherapy (surgery group) and 56 received only chemotherapy (chemotherapy group). The age, gender, International Staging System (ISS), fracture location, segment, visual analog scale (VAS), Oswestry Disability Index (ODI), comprehensive treatment satisfaction, stem cell transplantation, overall survival (OS), mortality rate, and the cause of death of patients were recorded; the mean follow-up time was 42.46 months.ResultsThe average age of patients in surgery and chemotherapy groups was 60.8 years and 58.1 years, and the mean survival time was 41.98 months and 43.30 months, respectively. The VAS score at 1 month and last follow-up after treatment in surgery group were significantly lower than those in the chemotherapy group (P < 0.05); the ODI at 1 month after treatment in the surgery group was significantly lower than that in the chemotherapy group (P < 0.05); no significant difference was observed in the 3-year mortality rate between surgery and chemotherapy groups. The number of patients who developed activity disorder in the surgery group was significantly less than that in the chemotherapy group (P < 0.05). The OS of patients in ISS stage III was significantly less than that in ISS stages I and II (P < 0.05).ConclusionsPKP/PVP surgery can greatly relieve the pain caused by fractures, reduce the risk of being completely bedridden and pulmonary infection, and improve the quality of life of patients; however, it did not affect mortality rate and overall survival time in patients.Trial registrationAs 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.

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Section: Discussionmentioning

confidence: 99%

PKP/PVP combine chemotherapy in the treatment of multiple myeloma patients with vertebral pathological fractures: minimum 3-year follow-up of 108 cases

Yao

2019

J Orthop Surg Res

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“…Spinal instabilite ve spinal kord basısı saptanmayan ancak şiddetli ağrı ve kompresyon kırıkları görülen hastalarda kifoplasti ya da vertebroplasti başarıyla uygulanan minimal invazif bir cerrahi yöntem olarak ön plana çıkmaktadır. [30] Hastanın yaşam beklentisini belirleyecek olan tedavinin kemoterapi olması itibariyle cerrahi girişimler mümkün olduğu kadar minimal tutulmalıdır. Hastanın kemoterapisi kesinlikle geciktirilmemeli ve artmış enfeksiyon riski göz önüne alınarak cerrahi planlama yapılmalıdır.…”

Section: Multipl Myelom Tedavisiunclassified

Bone Pathology in Multiple Myeloma: Diagnosis and Treatment

Okay¹

2020

bogazicitip

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Multiple myeloma is the most common primary bone disease. Incidence has been reported as 3/100.000 in the United States. This neoplasia is characterized by osteolytic bone destruction and monoclonal proliferation of plasma cells. Multiple myeloma is the most common haematologic malignancy after Non-Hodgkin lymphoma and the most common primary bone malignancy in elderly population. Orthopaedic complaints include pain, pathologic fracture, osteoporosis, hypercalcemia and spinal cord compression. Chemotherapy constitutes the main treatment. Surgical intervention should be as minimal as possible and chemotherapy should be started as soon as possible. The risk of infection should also be considered. This review aimed to synthesize the diagnosis and treatment of bone involvement in myeloma disease.

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“…Indications for surgical treatment of MM include: (i) spinal instability; (ii) potential or existing pathological fracture caused by MM; (iii) progressive impairment of neurological function due to spinal cord or nerve root compression caused by MM; (iv) intractable pain clearly attributable to a site of MBD; (v) solitary plasmacytoma of bone; (vi) soft tissue plasmacytoma in limbs or spine; (vii) pathological or potential fracture of a long bone; and (viii) needle or open biopsy providing pathological evidence for further treatment.…”

Section: Surgical Treatment Of Mbdmentioning

confidence: 99%

Consensus on Surgical Management of Myeloma Bone Disease

2016

Orthopaedic Surgery

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Myeloma bone disease (MBD), the skeletal lesions caused by multiple myeloma, is also known as skeletal related events and includes bone pain, osteoporosis, pathological fractures, osteolytic bone lesions, spinal instability, spinal cord and nerve root compression and extramedullary plasmacytoma. It is now generally accepted that patients with these complications usually require surgical management and that such treatment is safe and effective. The aims of surgical interventions are to alleviate pain, improve quality of life, treat potential or existing pathological fractures, decompress the spinal cord and nerve roots, and reestablish bone continuity. Thus far, there have not been uniform standards for surgical treatment of MBD. The Surgeon's Committee of the Chinese Myeloma Working Group has therefore achieved a consensus with the aim of providing guidance for clinicians and benefitting patients with MBD. This consensus focuses on the treatment of MBD, including its clinical definition and characteristics, diagnosis and surgical management. This expert consensus document was compiled after discussion and revision by experts from several relevant institutions in China. However, it is only an interim guide that cannot be enforced legally. It will be updated with development of new techniques of treatment.

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Surgery for plasma cell neoplasia patients with spinal instability or neurological impairment caused by spinal lesions as the first clinical manifestation

Abstract: Surgery may be beneficial to patients with spinal instability or neurological impairment caused by spinal lesions as the first clinical manifestation, in which MM patients with postoperative ambulatory ability display better prognosis.

Cited by 13 publications

References 19 publications

PKP/PVP combine chemotherapy in the treatment of multiple myeloma patients with vertebral pathological fractures: minimum 3-year follow-up of 108 cases

PKP/PVP combine chemotherapy in the treatment of multiple myeloma patients with vertebral pathological fractures: minimum 3-year follow-up of 108 cases

Bone Pathology in Multiple Myeloma: Diagnosis and Treatment

Consensus on Surgical Management of Myeloma Bone Disease

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