Percutaneous vertebroplasty and kyphoplasty in patients with multiple myeloma

Bartolozzi, Benedetta; Nozzoli, Chiara; Pandolfo, C.; Antonioli, Elisabetta; Guizzardi, Giancarlo; Morichi, R; Bosi, Alberto

doi:10.1111/j.1600-0609.2005.00573.x

Cited by 31 publications

(17 citation statements)

References 9 publications

(9 reference statements)

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“…In addition, many previous studies involving myeloma patients were nonspecific and focused on mixed populations of malignant compression fractures of any etiology or did not discriminate between kyphoplasty and vertebroplasty. 18,19,23,26 We intentionally sought to separate myeloma (a primary osteolytic cancer of the vertebral body) from other malignant neoplasms that can invade the spine because their pathophysiologic mechanisms differ and, thus, may confound or bias the results.…”

Section: Discussionmentioning

confidence: 99%

“…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.…”

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confidence: 99%

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Vertebroplasty in Multiple Myeloma: Outcomes in a Large Patient Series

McDonald¹,

Trout²,

Gray³

et al. 2008

AJNR Am J Neuroradiol

125

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BACKGROUND AND PURPOSE:Despite the literature supporting the efficacy of vertebroplasty for treatment of osteoporotic vertebral compression fractures, few reports exist documenting its use in the treatment of compression fractures in multiple myeloma patients. Accordingly, we sought to characterize the imaging characteristics, clinical course, and outcomes in myeloma patients treated with vertebroplasty.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Vertebroplasty in Multiple Myeloma: Outcomes in a Large Patient Series

McDonald¹,

Trout²,

Gray³

et al. 2008

AJNR Am J Neuroradiol

125

View full text Add to dashboard Cite

show abstract

“…Several reports have focused on the use of vertebroplasty, particularly in the treatment of osteolyses and compression fractures in myeloma patients (22)(23)(24)(25)(26)(27)(28)(29)(30). Conservative pain management with bed rest, bracing, bisphosphonates and analgesic drugs is often not sufficient to control the acute and chronic spinal pain accompanying pathologic fractures in myeloma patients.…”

Section: Discussionmentioning

confidence: 99%

CT fluoroscopy-guided percutaneous vertebroplasty in patients with multiple myeloma: analysis of technical results in 44 sessions with 67 vertebrae treated

Trumm

Jakobs²,

Pahl³

et al. 2011

Diagn Interv Radiol

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“…In accordance with out local policy agreed by our haematology and interventional radiology departments, all of our patients were treated with percutaneous vertebroplasty as opposed to balloon kyphoplasty, which involves the injection of cement under lower pressure into a cavity created by balloon inflation within the vertebra being treated,. The advantages of each type of procedure is a topic of much debate [14][15][16] , a full review of which is outside the scope of this article, However minimal vertebral height gain is the main differences achievable with kyphoplasty. This is however usually only a few millimetres and is balanced against longer procedure and hence anaesthetic time and higher procedure related costs.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous vertebroplasty to treat painful myelomatous vertebral deposits—long-term efficacy outcomes

2010

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Objectives. Developed for benign conditions including osteoporotic fractures and haemangiomas, vertebroplasty has since been employed in neoplastic lesions, including myeloma. Advances in myeloma treatments, yielding improved survival times, have led to an increasing need for effective therapies that improve quality of life. The first randomised trials of vertebroplasty to treat painful osteoporotic crush fractures, have cast doubt of its benefit over a placebo procedure, with a proposed rationale that fracture healing over time may account for the non-superiority results. However these findings cannot be extrapolated to myeloma, where the pathology is one of progressive bony destruction, coupled with a failure of new bone formation. Here, we present the outcome data for myeloma patients treated at our tertiary-referral centre over a 5yr period, focusing on both subjective and objective measures of efficacy and safety. Patients/Methods. Records were reviewed to extract pain-score, function and analgesia pre/post procedure. Where possible, patients were then contacted directly and asked to assess their benefit by grading change in pain-score, analgesia use and mobility. Performance status was assessed using the Eastern Cooperative Oncology Group (ECOG) scale.Results. Of 26 patients treated for painful, thoraco-lumbar lesions, 77% reported improved pain-score (P<0.003). Analgesia reduction, better mobility and improved performance-status were also seen. Conclusion. Our data support the consideration of vertebroplasty as a first-line treatment for painful, myelomatous vertebral disease. Prospective, randomised studies are now required to further define its role.Response to Reviewers: Please see the attached file for our response to the reviewers comments. Reviewers have now commented on your paper. You will see that they are advising that you revise your manuscript. If you are prepared to undertake the work required, I would be pleased to reconsider my decision.The reviewers' comments can be found at the end of this email or can be accessed by following the provided link.If you decide to revise the work, please submit a list of changes or a rebuttal against each point which is being raised when you submit the revised manuscript.Your revision is due by 10-07-2010.To submit a revision, go to http://aohe.edmgr.com/ and log in as an Author. You will see a menu item call Submission Needing Revision. You will find your submission record there. Percutaneous vertebroplasty would also be considered for patients not appropriate for surgery based on their performance status. This information has now beein included in the discussion as paragraph 5.>Because of the retrospective nature of this study, we are unable to provide accurate information on the number of patients who were offered vertebroplasty but declined the procedure. In answer to the reviewers enquiry, our lead myeloma haematology Consultant is able to provide an approximate estimate that 5% of patients offered vertebroplasty do accept and proceed to have the proced...

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Percutaneous vertebroplasty and kyphoplasty in patients with multiple myeloma

Abstract: A B Fig. 1. (A) Kyphoplasty: images before (sagittal CT scan), during (X-ray) and after (axial and sagittal CT scan) treatment. (B) Vertebroplasty: images before (axial CT scan), during (X-ray) and after (axial and sagittal CT scan) treatment.

Cited by 31 publications

References 9 publications

Vertebroplasty in Multiple Myeloma: Outcomes in a Large Patient Series

Vertebroplasty in Multiple Myeloma: Outcomes in a Large Patient Series

CT fluoroscopy-guided percutaneous vertebroplasty in patients with multiple myeloma: analysis of technical results in 44 sessions with 67 vertebrae treated

Percutaneous vertebroplasty to treat painful myelomatous vertebral deposits—long-term efficacy outcomes

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