[Multiple spinal myeloma and its surgical management]

Area of Science:

• Spinal oncology
• Surgical management of multiple myeloma
• Neurosurgery

Background:

• Multiple myeloma (MM) often involves spinal complications, including osteolysis, pain, and instability, necessitating surgical intervention.
• The management of spinal MM requires a multidisciplinary approach, balancing tumor suppression with supportive therapies like surgery.
• Evaluating surgical indications in spinal MM and solitary spinal plasmocytoma is crucial for optimizing patient outcomes.

Observation:

• A retrospective study evaluated 10 patients with spinal MM or solitary spinal plasmocytoma undergoing surgical procedures.
• Indications for surgery included progressing neurological deficit and refractory axial spinal pain.
• Surgical procedures ranged from palliative vertebroplasty to more radical somatectomy, tailored to disease extent and neurological status.

Findings:

• All surgical procedures achieved adequate pain control and prevented neurological deterioration throughout the follow-up period.
• No local tumor relapses or device stabilization failures were observed.
• The Tokuhashi score demonstrated the highest suitability among evaluated prognostic scoring systems for guiding surgical radicality.

Implications:

• Surgical intervention is a key component in managing spinal MM, addressing pain and neurological dysfunction.
• Favorable prognoses and improved survival rates in MM support the consideration of surgical therapy.
• While scoring systems can aid decision-making, careful clinical assessment is paramount to avoid potentially unnecessary radical procedures.