Percutaneous vertebroplasty for multiple myeloma of the cervical spine.
BACKGROUND
Spinal involvement is a common presentation of multiple myeloma (MM); however, the cervical spine is the least common site of myelomatous involvement. Few studies evaluate the results of percutaneous vertebroplasty (PV) in the treatment of MM of the spine. The purpose of this series is to report on the use of PV in the treatment of MM of the cervical spine and to review the literature.


METHODS
From January 1994 to October 2007, four patients (three men and one woman; mean age, 45 years) who underwent five PV for painful MM in the cervical spine were retrospectively reviewed. The pain was estimated by the patient on a verbal analogic scale. Clinical follow-up was available for all patients (mean, 27.5 months; range, 1-96 months).


RESULTS
The mean volume of cement injected per vertebral body was 2.3 +/- 0.8 mL (range, 1.0-4.0 mL) with a mean vertebral filling of 55.0 +/- 12.0% (range, 40.0-75.0%). Analgesic efficacy was achieved in all patients. One patient had a spinal instability due to a progression of spinal deformity noted on follow-up radiographs, without clinical symptoms. Cement leakage was detected in three (60%) of the five treated vertebrae. There was no clinical complication.


CONCLUSIONS
The present series suggests that PV for MM of the cervical spine is safe and effective for pain control; nonetheless, the detrimental impact of the disease on bone quality should prompt close radiological follow-up after PV owing to the risk of spinal instability.
Mont'Alverne
Francisco
F
Department of Neuroradiology, Groupe Hospitalier Pitié-Salpêtrière, Université Paris VI, 47 boulevard de l'Hôpital, Paris Cedex 13, France. fjmontalverne@hotmail.com
Vallée
Jean-Noel
JN
Guillevin
Remy
R
Cormier
Evelyne
E
Jean
Betty
B
Rose
Michelle
M
Caldas
José Guilherme
JG
Chiras
Jacques
J
D000328:Adult; D001843:Bone Cements / Q000627:therapeutic use; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications* / Q000628:therapy*; D019547:Neck Pain / Q000000981:diagnostic imaging / Q000209:etiology* / Q000517:prevention & control*; D011859:Radiography; D013125:Spinal Neoplasms / Q000150:complications* / Q000628:therapy*; D016896:Treatment Outcome; D054854:Vertebroplasty / Q000379:methods*
D001843:Bone Cements