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Surgery for vertebral involvement in multiple myeloma.

Pasquale Donnarumma1, Roberto Tarantino2, Marika Rullo3

  • 1Department of Neurology and Psychiatry, Division of Neurosurgery, "Sapienza" University of Rome, Rome, Italy - dott.pasquale.donnarumma@gmail.com.

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|October 17, 2015
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Summary

Surgery for multiple myeloma (MM) vertebral lesions shows variable outcomes. Thoracic lesions improved quality of life, but overall disability depends on the number of vertebrae affected by MM.

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Area of Science:

  • Spinal surgery
  • Oncology
  • Hematology

Background:

  • Multiple myeloma (MM) frequently involves the vertebral column.
  • New chemotherapy regimens were introduced in 2006, potentially altering treatment outcomes for MM.
  • Evaluating surgical outcomes for vertebral MM is crucial.

Purpose of the Study:

  • To assess the results of surgical interventions for vertebral involvement in multiple myeloma (MM).
  • To compare outcomes between operated and non-operated MM patients with vertebral lesions.
  • To understand the impact of vertebral MM on disability and quality of life post-chemotherapy advancements.

Main Methods:

  • Retrospective cohort study of MM patients with vertebral lesions (2006-2014).
  • Outcomes measured using Oswestry Disability Index (ODI) and EQ-5D.
  • Statistical analysis performed using SPSS v.19.

Main Results:

  • Approximately one-third of eligible MM patients required surgery for vertebral involvement.
  • Disability was primarily linked to the number of affected vertebrae.
  • Operated patients with thoracic lesions reported better quality of life and lower disability compared to non-operated counterparts.
  • No significant difference in disability or quality of life was found between operated and non-operated groups overall, considering age, levels, and follow-up.

Conclusions:

  • Around 40% of patients with spinal involvement undergo surgery.
  • Operated patients experience moderate disability, increasing with the number of affected vertebrae.
  • Quality of life is moderate overall, but higher for patients operated on for thoracic lesions.
  • Spinal surgeons must consider spine stability, deformity, fracture risk, and drug-resistant pain in managing vertebral MM.