Abstract
Mechanical stabilization of oncological vertebral fractures with cement augmentation is the first mechanism of pain relief, with or without restoration of vertebral body height. The aim of this study was to assess the safety and efficacy of vertebroplasty for painful vertebral body fractures in patients with multiple myeloma, in each phase of the disease. The authors reviewed a consecutive group of patients with multiple myeloma who underwent vertebroplasty at our Institute between November 2003 and December 2005. Twenty-eight levels were performed on 11 patients during 14 treatment sessions. All patients suffered from intractable back pain, and presented various lesion types (with and without fractures of posterior wall, and with and without epidural disease). The preoperative median visual analog scale (VAS) score was 7. The median duration of symptoms was 1.1 months. Eight patients were ambulating with orthopaedic devices (57%) in the pre-treatment period. Improvement or complete pain relief was observed in all patients (immediately in 8 cases, and after 2 days in 6 cases). The median VAS pain score decreased to 2. There was no symptomatic procedure-related complication. There were three cases (21%) of PMMA leakage: in the disc space in one case (7%), and in the anterior spinal canal in two cases (14%). Complete removal of orthopaedic devices was obtained in five patients (36%). No new deformation or collapse of the treated vertebrae was observed during the follow-up (range 1 day-25 months). In conclusion, vertebroplasty is a safe and efficient procedure in the treatment of painful vertebral body fractures in patients with multiple myeloma, without potential contraindications, such as fractures of the posterior wall or epidural disease. We also treated three and more levels in 28% of cases in a single session without complications. Due to the early pain relief and the low complication rate, it is possible to expand the indication to vertebroplasty for the prophylactic augmentation of those vertebral bodies at risk of fracture in which significant neoplastic substitution of the body is present.
| Original language | English |
|---|---|
| Pages (from-to) | 151-157 |
| Number of pages | 7 |
| Journal | Neurological Sciences |
| Volume | 31 |
| Issue number | 2 |
| DOIs | |
| Publication status | Published - Apr 2010 |
Fingerprint
Keywords
- Bone cement
- Myeloma
- Spine
- Vertebral fracture
- Vertebroplasty
ASJC Scopus subject areas
- Clinical Neurology
- Psychiatry and Mental health
- Dermatology
Cite this
Vertebroplasty for pain relief and spinal stabilization in multiple myeloma. / Tancioni, Flavio; Lorenzetti, Martin; Navarria, Pierina; Nozza, Andrea; Castagna, Luca; Gaetani, Paolo; Aimar, Enrico; Levi, Daniel; Di Ieva, Antonio; Pisano, Patrizia; Santoro, Armando; Scorsetti, Marta; Y Baena, Riccardo Rodriguez.
In: Neurological Sciences, Vol. 31, No. 2, 04.2010, p. 151-157.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Vertebroplasty for pain relief and spinal stabilization in multiple myeloma
AU - Tancioni, Flavio
AU - Lorenzetti, Martin
AU - Navarria, Pierina
AU - Nozza, Andrea
AU - Castagna, Luca
AU - Gaetani, Paolo
AU - Aimar, Enrico
AU - Levi, Daniel
AU - Di Ieva, Antonio
AU - Pisano, Patrizia
AU - Santoro, Armando
AU - Scorsetti, Marta
AU - Y Baena, Riccardo Rodriguez
PY - 2010/4
Y1 - 2010/4
N2 - Mechanical stabilization of oncological vertebral fractures with cement augmentation is the first mechanism of pain relief, with or without restoration of vertebral body height. The aim of this study was to assess the safety and efficacy of vertebroplasty for painful vertebral body fractures in patients with multiple myeloma, in each phase of the disease. The authors reviewed a consecutive group of patients with multiple myeloma who underwent vertebroplasty at our Institute between November 2003 and December 2005. Twenty-eight levels were performed on 11 patients during 14 treatment sessions. All patients suffered from intractable back pain, and presented various lesion types (with and without fractures of posterior wall, and with and without epidural disease). The preoperative median visual analog scale (VAS) score was 7. The median duration of symptoms was 1.1 months. Eight patients were ambulating with orthopaedic devices (57%) in the pre-treatment period. Improvement or complete pain relief was observed in all patients (immediately in 8 cases, and after 2 days in 6 cases). The median VAS pain score decreased to 2. There was no symptomatic procedure-related complication. There were three cases (21%) of PMMA leakage: in the disc space in one case (7%), and in the anterior spinal canal in two cases (14%). Complete removal of orthopaedic devices was obtained in five patients (36%). No new deformation or collapse of the treated vertebrae was observed during the follow-up (range 1 day-25 months). In conclusion, vertebroplasty is a safe and efficient procedure in the treatment of painful vertebral body fractures in patients with multiple myeloma, without potential contraindications, such as fractures of the posterior wall or epidural disease. We also treated three and more levels in 28% of cases in a single session without complications. Due to the early pain relief and the low complication rate, it is possible to expand the indication to vertebroplasty for the prophylactic augmentation of those vertebral bodies at risk of fracture in which significant neoplastic substitution of the body is present.
AB - Mechanical stabilization of oncological vertebral fractures with cement augmentation is the first mechanism of pain relief, with or without restoration of vertebral body height. The aim of this study was to assess the safety and efficacy of vertebroplasty for painful vertebral body fractures in patients with multiple myeloma, in each phase of the disease. The authors reviewed a consecutive group of patients with multiple myeloma who underwent vertebroplasty at our Institute between November 2003 and December 2005. Twenty-eight levels were performed on 11 patients during 14 treatment sessions. All patients suffered from intractable back pain, and presented various lesion types (with and without fractures of posterior wall, and with and without epidural disease). The preoperative median visual analog scale (VAS) score was 7. The median duration of symptoms was 1.1 months. Eight patients were ambulating with orthopaedic devices (57%) in the pre-treatment period. Improvement or complete pain relief was observed in all patients (immediately in 8 cases, and after 2 days in 6 cases). The median VAS pain score decreased to 2. There was no symptomatic procedure-related complication. There were three cases (21%) of PMMA leakage: in the disc space in one case (7%), and in the anterior spinal canal in two cases (14%). Complete removal of orthopaedic devices was obtained in five patients (36%). No new deformation or collapse of the treated vertebrae was observed during the follow-up (range 1 day-25 months). In conclusion, vertebroplasty is a safe and efficient procedure in the treatment of painful vertebral body fractures in patients with multiple myeloma, without potential contraindications, such as fractures of the posterior wall or epidural disease. We also treated three and more levels in 28% of cases in a single session without complications. Due to the early pain relief and the low complication rate, it is possible to expand the indication to vertebroplasty for the prophylactic augmentation of those vertebral bodies at risk of fracture in which significant neoplastic substitution of the body is present.
KW - Bone cement
KW - Myeloma
KW - Spine
KW - Vertebral fracture
KW - Vertebroplasty
UR - http://www.scopus.com/inward/record.url?scp=77953537744&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=77953537744&partnerID=8YFLogxK
U2 - 10.1007/s10072-009-0197-5
DO - 10.1007/s10072-009-0197-5
M3 - Article
C2 - 20076982
AN - SCOPUS:77953537744
VL - 31
SP - 151
EP - 157
JO - Neurological Sciences
JF - Neurological Sciences
SN - 1590-1874
IS - 2
ER -