title: Vertebral augmentation in patients with multiple myeloma: a pooled analysis of published case series.
abstract: OBJECTIVE
  Studies examining the efficacy of vertebroplasty and kyphoplasty in patients with vertebral fractures from multiple myeloma are limited. We sought to perform a systematic review of published case studies examining changes in pain, disability, and analgesic drug use in patients with multiple myeloma who have undergone vertebral augmentation.
  
  
  METHODS
  We performed a pooled analysis of published case series of vertebral augmentation in patients with multiple myeloma. Twenty-three studies (9 kyphoplasty, 12 vertebroplasty, and 2 of both) with data on 923 patients were identified from a PubMed search. Quantitative outcome data included the Visual Analog Scale, the Brief Pain Inventory, the Short Form 36 Health Survey, and the Owestry Disability Index. Time periods were consolidated into 3: postoperatively ≤1 week, 1 week to 1 year, and ≥1 year. Change in analgesic use was also studied. Data were compared by using nonparametric tests and matched t tests for temporally linked data.
  
  
  RESULTS
  Patients achieved a decrease in pain across all consolidated time periods. Pain, as measured on a 10-point scale, decreased by 4.8 points up to 1 week, 4.6 points up to 1 year, and 4.4 points after a year (P < .001). Decrease in pain was apparent early after treatment and was sustained with time. Kyphoplasty and vertebroplasty were equally effective in reducing pain scores because differences between procedures for each time period were insignificant (P < .9 for <1 week, P < 1.0 for ≤1 year, and P < .9 for >1 year.
  
  
  CONCLUSIONS
  Our analysis demonstrates that vertebral augmentation is effective in patients with multiple myeloma.
authors.affiliation: Departments of Radiology.
authors.forename: O A
authors.initials: OA
authors.lastname: Khan
authors.forename: W
authors.initials: W
authors.lastname: Brinjikji
authors.forename: D F
authors.initials: DF
authors.lastname: Kallmes
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015984:Causality; D015897:Comorbidity; D006801:Humans; D008875:Middle Aged; D009101:Multiple Myeloma / Q000453:epidemiology* / Q000601:surgery*; D010146:Pain / Q000453:epidemiology* / Q000517:prevention & control*; D010147:Pain Measurement / Q000706:statistics & numerical data; D015995:Prevalence; D039781:PubMed / Q000706:statistics & numerical data; D012307:Risk Factors; D013125:Spinal Neoplasms / Q000453:epidemiology* / Q000601:surgery*; D016896:Treatment Outcome; D054854:Vertebroplasty / Q000706:statistics & numerical data*