Management of painful spinal lesions caused by multiple myeloma using percutaneous acrylic cement injection.
OBJECTIVE
Spinal lesions with marked destruction are common site of morbidity in patients with multiple myeloma causing serious clinical symptoms. The aim of the study was to evaluate the therapeutic benefit of percutaneous vertebroplasty (PVP) in treating vertebral body lesions in patients suffering from multiple myeloma.


METHODS
Twenty nine patients (55 vertebral bodies) were treated after complete diagnostic evaluation, preparation and obtaining informed consent. Needle position and acrylic material injection was performed under fluoroscopic guidance.


RESULTS
Average visual analogue score dropped from 7.8 before to 2.3 after the intervention. Soft tissue leak was present at 9 treated levels, small epidural cement collection at 5, venous leak at 4 and intradiscal leak at 3 levels without any clinically manifest complications. The effects of PVP were stable in all of the patients at 12 months follow-up. Subjective outcome scores collected through follow-up showed improvement of +1.45 in pain, + 1.15 in ambulation and + 1.23 in medication use. There were recurrence of back pain in 9 patients at non-treated levels due to the new lesions.


CONCLUSIONS
In our series, PVP of painful lesions caused by multiple myeloma provides immediate and long-term pain relief. The procedure is safe and, despite of the present leakage of cement, may be performed on outpatients basis.
Bosnjaković
P
P
Institute of Radiology Clinical Center Nis, Nis, Serbia.
Ristić
S
S
Mrvić
M
M
Miljković
A E
AE
Vukićević
T
T
Marjanović
G
G
Macukanović-Golubović
L
L
D000368:Aged; D001416:Back Pain / Q000209:etiology / Q000628:therapy*; D001843:Bone Cements / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications*; D010147:Pain Measurement; D019904:Polymethyl Methacrylate / Q000627:therapeutic use*; D015641:Radiography, Interventional; D013122:Spinal Diseases / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D054854:Vertebroplasty
D001843:Bone Cements; D019904:Polymethyl Methacrylate