Bone marrow washout for multilevel vertebroplasty in multiple myeloma spinal involvement. Technical note

Area of Science:

• Orthopedic Surgery
• Oncology
• Radiology

Background:

• Multiple myeloma (MM) frequently causes vertebral involvement, necessitating surgical intervention for pain and disability.
• Multilevel surgical treatment is often required for spinal MM to facilitate oncological care.

Purpose of the Study:

• To describe the clinical application of the washout technique for multilevel vertebroplasty in MM patients with diffuse spinal involvement.
• To evaluate the safety and efficacy of this technique in reducing pulmonary fat embolism risk and increasing cement/treated levels per stage.

Main Methods:

• The study involved three patients with thoracolumbar diffuse spinal involvement due to multiple myeloma.
• The washout technique was performed prior to multilevel vertebroplasty, with the surgical procedure and literature reviewed.

Main Results:

• The washout technique proved clinically safe and effective in pain reduction without significant complications.
• One patient underwent a six-level vertebroplasty, allowing greater cement volume and timely initiation of oncological therapy.

Conclusions:

• Multilevel vertebroplasty in spinal MM offers pain relief, avoids repeat surgeries, and expedites oncological treatment.
• While pulmonary embolism is a rare but serious risk, this technique showed no significant complications in the series, warranting further investigation.