Percutaneous vertebroplasty in multiple myeloma: prospective long-term follow-up in 106 consecutive patients

Cardiovasc Intervent Radiol. 2012 Feb;35(1):139-45. doi: 10.1007/s00270-011-0111-4. Epub 2011 Feb 9.

Abstract

Purpose: Percutaneous vertebroplasty (PV) is a minimally invasive procedure involving the injection of bone cement within a collapsed vertebral body. Although this procedure was demonstrated to be effective in osteoporosis and metastases, few studies have been reported in cases of multiple myeloma (MM). We prospectively evaluated the safety and efficacy of PV in the treatment of vertebral compression fractures (VCFs) resulting from MM.

Materials and methods: PV was performed in 106 consecutive MM patients who had back pain due to VCFs, the treatment of which had failed conservative therapies. Follow-up (28.2 ± 12.1 months) was evaluated at 7 and 15 days as well as at 1, 3, 6, 12, 18, and every 6 months after PV. Visual analog scale (VAS) pain score, opioid use, external brace support, and Oswestry Disability Index (ODI) score were recorded.

Results: The median pretreatment VAS score of 9 (range 4-10) significantly (P < 0.001) decreased to 1 (range 0-9) after PV. Median pre-ODI values of 82% (range 36-89%) significantly improved to 7% (range 0-82%) (P < 0.001). Differences in pretreatment and posttreatment use of analgesic drug were statistically significant (P < 0.001). The majority of patients (70 of 81; 86%) did not use an external brace after PV (P < 0.001).

Conclusion: PV is a safe, effective, and long-lasting procedure for the treatment of vertebral compression pain resulting from MM.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Bone Cements*
  • Braces
  • Disability Evaluation
  • Female
  • Fluoroscopy
  • Follow-Up Studies
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Multiple Myeloma / complications*
  • Multiple Myeloma / diagnostic imaging
  • Multiple Myeloma / therapy*
  • Pain Measurement
  • Prospective Studies
  • Spinal Cord Compression / diagnostic imaging
  • Spinal Cord Compression / etiology*
  • Spinal Cord Compression / therapy*
  • Spinal Neoplasms / complications*
  • Spinal Neoplasms / diagnostic imaging
  • Spinal Neoplasms / therapy*
  • Statistics, Nonparametric
  • Tomography, X-Ray Computed / methods*
  • Treatment Outcome
  • Vertebroplasty / methods*

Substances

  • Bone Cements