Kyphoplasty enhances function and structural alignment in multiple myeloma.
We prospectively evaluated 19 patients with multiple myeloma who had kyphoplasty for vertebral compression fractures. Functional status was assessed preoperatively and 3 months postoperatively using the Oswestry Disability Index. Restoration of anterior and midvertebral height was assessed using lateral radiographs. Meaningful improvement occurred in 16 of 19 patients, with a reduction of the average Oswestry Disability Index from 49 +/- 16.6 to 32.6 +/- 13.6. Partial restoration of anterior vertebral body height was achieved in 76% of levels with an average of 37.8% restoration of the defect. Partial restoration of midvertebral body height was achieved in 91% of levels with an average restoration of 53.4% of the defect. There were no significant complications. These results were compared with results of a cohort of 26 patients with osteoporotic compression fractures treated with kyphoplasty at 37 levels. There was no difference between the groups in terms of Oswestry Disability Index improvement and midvertebral height restoration after 3 months. Greater anterior vertebral height restoration was achieved in the osteoporotic group (51.2% versus 37.8%). Kyphoplasty is a safe treatment modality for myeloma-related vertebral compression fractures. Efficacy in terms of pain relief and functional outcome is comparable with the results in patients with osteoporosis.
Lane
Joseph M
JM
Department of Metabolic Bone Diseases, Hospital for Special Surgery, New York, NY 10021, USA. lanej@hss.edu
Hong
Richard
R
Koob
Jason
J
Kiechle
Tamara
T
Niesvizky
Ruben
R
Pearse
Roger
R
Siegel
David
D
Poynton
Ashley R
AR
D000368:Aged; D001843:Bone Cements; D002404:Catheterization / Q000009:adverse effects; D004185:Disability Evaluation; D005260:Female; D005598:Fractures, Spontaneous / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D007738:Kyphosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D008159:Lumbar Vertebrae; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D010147:Pain Measurement; D019904:Polymethyl Methacrylate / Q000008:administration & dosage; D011859:Radiography; D016103:Spinal Fractures / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D013904:Thoracic Vertebrae
D001843:Bone Cements; D019904:Polymethyl Methacrylate