Medium‐term results of percutaneous vertebroplasty in multiple myeloma

Abstract

Vertebral compression fractures (VCFs) are common in multiple myeloma (MM). Percutaneous vertebroplasty (PVP) is used to stabilize vertebral collapse and treat the pain. Few studies have been carried out on PVP in MM and follow-up has tended to be short. We have prospectively evaluated the safety and efficacy of PVP in the VCFs resulting from MM or plasmacytomas. Nineteen PVP were performed in 12 consecutive patients. We monitored their pain and functional status using visual analog (VAS) and Eastern Cooperative Oncology Group (ECOG) scale, respectively. For a subjective assessment, every patient was asked about his/her degree of satisfaction. The mean age of the participants was 66 yr. Significant improvement occurred 1 d after PVP according to the VAS score (7.5 pre-PVP to 3.7, P < 0.0001) and ECOG assessment (3.1 to 2.5, P = 0.002). This significant improvement was maintained after 3.2 yr of follow-up. Sixty-three percent of patients were highly satisfied with the result of the PVP and 37% were satisfied. The peri-operative mortality was 0%. Leakage of the cement outside of the vertebral body was noted in 16 of 19 injected vertebrae (84%) but none of the patients developed any clinical or neurological symptoms. At the last follow-up, no further collapse in the treated or neighboring vertebrae was noted. VCFs caused by MM or plasmacytomas can be effectively treated by vertebroplasty. PVP is associated with early clinical improvement of pain and function and can be maintained after a long follow-up without major procedure-related complications.

Percutaneous Vertebroplasty in Multiple Myeloma: Prospective Long-Term Follow-Up in 106 Consecutive Patients

“…Preliminary retrospective studies have demonstrated the effectiveness of PV [16,20] and KP [21,22] in controlling pain and improving the quality of life of patients with painful MM of the spine. Few studies have prospectively analyzed the clinical outcomes achieved by PV [23] and KP [17] in relatively small series of patients. Both procedures are minimally invasive, can be performed with the patient under local anesthesia, seem to achieve the same clinical outcome [21] (i.e.…”

Vertebroplasty in Multiple Myeloma: Outcomes in a Large Patient Series

“…Several small studies and case series have demonstrated a beneficial effect, 1,2,[17][18][19][20][21][22][23][24][25][26][27][28][29][30][31] but the largest sample size is composed of only 18 patients. Many barriers prevent the accumulation of a large patient cohort in the myeloma population, and these include reduced survival time of myeloma patients, the relative rarity of vertebroplasty treatment in myelomatous fractures, and a higher threshold of treatment criteria for patients with diffuse disease.…”

Percutaneous Vertebroplasty for Pathological Vertebral Compression Fractures Secondary to Multiple Myeloma – Medium-Term and Long-Term Assessment of Pain Relief and Quality of Life

“…The proportion of patients with good analgesic results after VP is high, ranging from 67% to 100%, while up to 70% report an improvement in active locomotion [4,9,12,[14][15][16]. The percentage of patients in the present study who reported a significant reduction of pain was as high as 92.3%.…”

“…Complications can arise from leakage of the cement outside the vertebrae. Although this occurs quite often, it does not usually result in clinically significant symptoms of compression [11,12]. Penetration of the cement into the paravertebral veins can be dangerous, however, as it may lead to the rare complication of pulmonary embolism (in 1.7% of cases).…”