title: Partial tumor resection combined with chemotherapy for multiple myeloma spinal cord compression.
abstract: BACKGROUND
  Some controversies about the optimal therapy for multiple myeloma (MM) spinal cord compression are still presented. This study was conducted to investigate the efficacy of partial tumor resection combined with chemotherapy for MM spinal cord compression.
  
  
  METHODS
  Eleven patients were diagnosed with MM spinal cord compression. Radiological examinations manifested 12 spinal lesions on 11 patients. All patients were treated with partial tumor resection with adjuvant chemotherapy. The mean procedure time, the mean blood loss, visual analog scale score, Oswestry Disability Index (ODI) score, neurological status, complication, recurrence, and quality of life were evaluated.
  
  
  RESULTS
  Eleven patients were followed up with a mean of 25.1 months. The mean procedure time was 152.6 ± 30.4 min, and the mean blood loss was 396.4 ± 82.7 ml. Overall pain control rate was 89 %, with complete pain relief in 64 %, and partial pain relief in 25 %. The median pre-ODI values of 85 % significantly improved to 12 % at the last follow-up. Neurological improvement of one to two grades was observed 6 months postoperatively. Complications included pleural effusion, titanium cage loose, and thrombocytopenia in three patients each. Local recurrence was 18.2 %. One patient died of pulmonary infection. Quality of life improved from 39 % before surgery to 81 % in ten survivors at the last follow-up.
  
  
  CONCLUSIONS
  Partial tumor resection combined with chemotherapy seems to be an effective treatment for MM spinal cord compression owing to the minor surgical trauma, fewer complications, and effective pain control. Total resection of the tumor is not necessary for MM of the spine.
authors.affiliation: Department of Orthopaedics, The Second Hospital of An Hui Medical University, Hefei, Anhui Province, People's Republic of China, qjpaper@sina.cn.
authors.forename: Jun
authors.initials: J
authors.lastname: Qian
authors.forename: Juehua
authors.initials: J
authors.lastname: Jing
authors.forename: Dasheng
authors.initials: D
authors.lastname: Tian
authors.forename: Huilin
authors.initials: H
authors.lastname: Yang
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications* / Q000401:mortality; D009367:Neoplasm Staging; D011183:Postoperative Complications; D011379:Prognosis; D011788:Quality of Life; D013117:Spinal Cord Compression / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D013125:Spinal Neoplasms / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D015996:Survival Rate