Tactics of Surgical Treatment for Myeloma Involvement of the Spine and Spinal Cord

Abstract

Objectives. To analyze the efficacy of contemporary decompressive-and-stabilizing techniques, including percutaneous vertebroplasty, in patients with a spine and spinal cord myelomatosis (SSCM). Material and Methods. Seventy-two patients with SSCM were evaluated with respect to the results of treatment. Sixty-two patients underwent surgical interventions followed by radiotherapy and chemotherapy: open interventions were performed in 53 (85.5 %) patients and percutaneous vertebroplasty (PVP) – in 9 (14.5 %). Ten patients underwent only a specific therapy for SSCM. Pain regression, neurologic state and quality of life were evaluated after surgery. Results. Radiotherapy and chemotherapy are the methods of choice for SSCM. However in some cases with increasing neurologic deficit, intractable pains and instability of an involved spine segment a surgical intervention is necessary and capable to prevent catastrophic complications. Best results, regarding neurologic impairments and quality of life, were achieved in a group of patients in whom decompressiveand- stabilizing procedures were performed. Conclusion. PVP is a minimally invasive procedure ensuring quick regression of a pain syndrome and prevention of pathologic fractures in patients with myelomatosis of the spine.