[Spinal cord compression in multiple myeloma. Study of 10 cases]

Ten cases of multiple myeloma with spinal cord compression are reported. The compression was located in the thoracic spine in 9 cases and in the cervical spine in 1 case. It led to the discovery of the myeloma in 4 cases. Three patients suffered, during several months, from local pain aggravated by activity and from slight and slowly progressive neurologic symptoms resembling intermittent claudication. At the time of diagnosis, sphincter dysfunction was observed only in patients with low thoracic cord compressions. In 4 cases, lesions were first treated by radiotherapy which did not produce regression of the compression. Tumor excision surgery was carried out seven times, once after failure of radiotherapy. In 6 cases an definite and steady regression of the neurological symptoms was achieved. Survival varied from 10 months to 7.5 years after identification of spinal cord compression. Survival was equal to or more than 3 years in 4 patients and will probably reach 3 years in another. Thus spinal cord compression is not by itself a sign indicating a poor short term prognosis in multiple myeloma. It should be treated by excision surgery, then by chemotherapy as in multiple myeloma at other sites.