Mid-term outcomes after radiofrequency-targeted vertebral augmentation in the treatment of myeloma associated vertebral fractures.
BACKGROUND
Myeloma patients often suffer from painful vertebral fractures (VCF) which impair their quality of life. Common methods for augmentation of the vertebrae are vertebroplasty, kyphoplasty and radiofrequency-targeted vertebral augmentation (RF-TVA).


OBJECTIVE
This study evaluates the long-term effectiveness and safety of RF-TVA in the treatment of myeloma associated VCF.


METHODS
Eighty-seven myeloma patients (mean age: 64.7 ± 9.5 years) with VCF were treated with RF-TVA. Patient data were assessed preoperatively and in five postoperative examinations up to 12 months. Pain was measured with the visual analogue scale (VAS) and the impairment was evaluated with the Oswestry-Disability-Index (ODI) at each examination. In addition, the mid vertebral height, kyphosis angle, and additional fractures were evaluated by x-rays. Furthermore, cement leakage was documented.


RESULTS
The VAS values were significantly improved in comparison to the preoperative values (p≤ 0.001), but slightly fluctuating during the follow-up period. The ODI was also significantly improved (p≤ 0.001), but it showed a worsening from the 12 months evaluation to the 24 months evaluation. The kyphosis angle and the vertebral height were significantly improved after surgery (p = 0.03, p ≤ 0.001), but worsened steadily to the last follow up examination. Cement leakage was asymptomatic and occurred in 18% of the patients. In 10% of the patients additional fractures were detected in the 24 months evaluation.


CONCLUSIONS
The results of our study show that RF-TVA is a safe treatment for myeloma associated vertebral compression fractures, which achieves an acceptable improvement of patient's pain and quality of life.
Thaer
T
Ali
Rahel
R
Bornemann
Philip P
PP
Roessler
Kirsten
K
Sander
Dieter C
DC
Wirtz
Robert
R
Pflugmacher
Sönke P
SP
Frey
D000368:Aged; D005260:Female; D006801:Humans; D058498:Kyphoplasty / Q000295:instrumentation* / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications*; D011788:Quality of Life; D016103:Spinal Fractures / Q000209:etiology* / Q000601:surgery*
RF-TVA; augmentation; myeloma; vertebral fracture