Diagnosis and surgical therapy of plasma cell neoplasia of the spine.
Presented is a retrospective analysis of 27 patients with plasma cell neoplasms of the spine treated by surgery. Multiple myeloma was confirmed in 22 (81%) and solitary plasmacytoma in 5 patients (19%), assessed at the time of surgery. Nineteen patients (70%) with the preliminary diagnosis of malignancy of unknown etiology were admitted for surgery. In 23 patients (85%) the essential symptom was back pain, which preceded surgery by an average of 4 months. Thirteen patients (48%) were bedridden due to tumor spinal cord compression, on average for 7 days before undergoing surgery. Only 5 out of 13 bedridden patients (38%) regained the ability to walk after surgery and 8 patients (62%) remained bedridden despite successful surgical decompression of the spinal cord. The difference of survival of the patients between bedridden and able to walk prior to surgery was statistically significant (Cox's F-Test = 0.005). Key words: plasma cell neoplasia, spinal cord compression, late diagnosis, outcome.
Rehak
S
S
Department of Neurosurgery, Charles University, Teaching Hospital, Hradec Kralove, Czech Republic. rehak@lfhk.cuni.cz
Maisnar
V
V
Malek
V
V
Cesak
T
T
Ryska
P
P
Bartos
M
M
Talab
R
R
D000328:Adult; D000368:Aged; D019299:Decompression, Surgical; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D054219:Neoplasms, Plasma Cell / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery*; D019635:Neurosurgical Procedures; D020127:Recovery of Function; D012189:Retrospective Studies; D013117:Spinal Cord Compression / Q000209:etiology / Q000601:surgery; D013125:Spinal Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery*; D016896:Treatment Outcome