Maintained pain reduction in five patients with multiple myeloma 12 months after treatment of the involved cervical vertebrae with vertebroplasty.
OBJECTIVE
To evaluate in a prospective study the clinical and radiographic outcome of vertebroplasty in patients with osteolytic lesions of the cervical spine caused by multiple myeloma.


METHODS
Pathological vertebral fractures associated with multiple myeloma were treated in five patients. Vertebroplasty was performed in 12 vertebral bodies. Symptomatic levels were identified by correlating the clinical presentation with magnetic resonance imaging (MRI), conventional radiographs, and computed tomography (CT). During the 12-month follow-up, pain symptoms were measured on a self-reported visual analog scale (VAS), neck pain disability index (NPDI, range 0-100%), and cervical spine functional score (CSFS, range 0-100). Medical imaging was performed pre- and postoperatively and after 3, 6, and 12 months. The vertebral height was measured to assess the restoration of the sagittal alignment.


RESULTS
The median pain scores (VAS) as well as the NPDI and CSFS decreased significantly after vertebroplasty (P<0.05). Cement leakage occurred in two of 12 vertebral bodies (16.6%), without clinical relevance. The vertebral body height was stabilized during follow-up.


CONCLUSIONS
Vertebroplasty in the cervical spine is an effective open surgical procedure for the stabilization of pathological vertebral fractures caused by multiple myeloma leading to a statistically significant reduction of pain status. Vertebral body height is stabilized and further deformities are avoided.
Pflugmacher
R
R
Centrum für Muskuloskeletale Chirurgie and Abteilung für Strahlenheilkunde, Charité - Universitätsmedizin Berlin, Campus Virchow-Klinikum, Berlin, Germany. robert.pflugmacher@charite.de
Schleicher
P
P
Schröder
R J
RJ
Melcher
I
I
Klostermann
C K
CK
D000368:Aged; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging; D005260:Female; D005598:Fractures, Spontaneous / Q000628:therapy*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000628:therapy*; D010146:Pain / Q000503:physiopathology*; D010147:Pain Measurement; D011446:Prospective Studies; D016103:Spinal Fractures / Q000628:therapy*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome