title: Effect of Systemic Therapies on Outcomes following Vertebroplasty among Patients with Multiple Myeloma.
abstract: The role of vertebroplasty in patients with myeloma remains relatively undefined. Accordingly, we sought to better define the efficacy of vertebroplasty for myeloma-associated fractures and determine the effect of procedure timing relative to the initiation of systemic therapy on outcomes and complication rates.
  
  
  
  Clinical, laboratory, and medication data were retrieved for 172 patients with multiple myeloma treated with vertebroplasty since October 2000. Quantitative outcome data (Roland-Morris Disability Questionnaire [scale, 0-24] and the Numeric Rating Scale [0-10] for pain at rest and with activity) were collected immediately pre- and postoperatively and at 1 week, 1 month, 6 months, and 1 year following vertebroplasty. Patients with ≥50% improvement on the Numeric Rating Scale and ≥40% improvement on the Roland-Morris Disability Questionnaire were classified as "responders." Peri- and postoperative complications were also collected.
  
  
  
  Significant median improvement in the Roland-Morris Disability and rest and activity Numeric Rating Scale scores (15, 2, and 6 points, respectively; P < .0001) persisted at 1 year without significant change from the immediate postoperative scores (P > .36). Patients on systemic therapy at the time of vertebroplasty were more likely to achieve "responder status," compared with patients not on systemic therapy, for the Numeric Rating Scale pain at rest score (P < .01) and the Roland-Morris Disability Questionnaire score (P < .003), with no difference in complication rates (χ2= 0.17, P = .68).
  
  
  
  Vertebroplasty is an effective therapy for patients with myeloma with symptomatic compression fractures. Favorable outcomes are more likely to be achieved when spinal augmentation is performed after systemic therapy is initiated. Complication rates were not affected by the timing of systemic therapy.
authors.affiliation: From the Departments of Radiology (R.J.M., J.S.M, D.F.K., V.T.L., F.E.D., J.T.W., K.R.T., P.H.L.) mcdonald.robert@mayo.edu.
authors.forename: R J
authors.identifier: 0000-0002-6409-6799
authors.initials: RJ
authors.lastname: McDonald
authors.affiliation: From the Departments of Radiology (R.J.M., J.S.M, D.F.K., V.T.L., F.E.D., J.T.W., K.R.T., P.H.L.).
authors.forename: J S
authors.identifier: 0000-0001-8142-8233
authors.initials: JS
authors.lastname: McDonald
authors.affiliation: From the Departments of Radiology (R.J.M., J.S.M, D.F.K., V.T.L., F.E.D., J.T.W., K.R.T., P.H.L.).|Neurosurgery (D.F.K.).
authors.forename: D F
authors.identifier: 0000-0002-8495-0040
authors.initials: DF
authors.lastname: Kallmes
authors.affiliation: From the Departments of Radiology (R.J.M., J.S.M, D.F.K., V.T.L., F.E.D., J.T.W., K.R.T., P.H.L.).
authors.forename: V T
authors.identifier: 0000-0002-8713-8293
authors.initials: VT
authors.lastname: Lehman
authors.affiliation: From the Departments of Radiology (R.J.M., J.S.M, D.F.K., V.T.L., F.E.D., J.T.W., K.R.T., P.H.L.).
authors.forename: F E
authors.identifier: 0000-0001-9458-8017
authors.initials: FE
authors.lastname: Diehn
authors.affiliation: From the Departments of Radiology (R.J.M., J.S.M, D.F.K., V.T.L., F.E.D., J.T.W., K.R.T., P.H.L.).
authors.forename: J T
authors.identifier: 0000-0001-5187-2333
authors.initials: JT
authors.lastname: Wald
authors.affiliation: From the Departments of Radiology (R.J.M., J.S.M, D.F.K., V.T.L., F.E.D., J.T.W., K.R.T., P.H.L.).
authors.forename: K R
authors.identifier: 0000-0002-7084-3156
authors.initials: KR
authors.lastname: Thielen
authors.affiliation: Hematology (A.D.), College of Medicine, Mayo Clinic, Rochester, Minnesota.
authors.forename: A
authors.identifier: 0000-0001-8780-9512
authors.initials: A
authors.lastname: Dispenzieri
authors.affiliation: From the Departments of Radiology (R.J.M., J.S.M, D.F.K., V.T.L., F.E.D., J.T.W., K.R.T., P.H.L.).
authors.forename: P H
authors.identifier: 0000-0003-4660-7644
authors.initials: PH
authors.lastname: Luetmer
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D050815:Fractures, Compression / Q000209:etiology / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications* / Q000628:therapy*; D016103:Spinal Fractures / Q000209:etiology / Q000601:surgery*; D016896:Treatment Outcome; D054854:Vertebroplasty / Q000379:methods*