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Journal of Spinal Disorders & Techniques:
doi: 10.1097/BSD.0b013e318260a076
Original Article: PDF Only

Functional Outcomes and Height Restoration for Patients With Multiple Myeloma-Related Osteolytic Vertebral Compression Fractures Treated With Kyphoplasty

Julka, Abhishek MD; Tolhurst, Stephen R. MD; Srinivasan, Ramesh C. MD; Graziano, Gregory P. MD

Published Ahead-of-Print
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Abstract

Study Design: Retrospective review of pathologic vertebral fractures related to multiple myeloma.

Objective: To report functional status and height restoration for 32 patients treated with kyphoplasty for multiple myeloma-related vertebral compression fractures.

Summary of Background Data: Multiple myeloma can cause significant bony resorption, and vertebral involvement is extremely common. Compression fractures due to myelomatous vertebral metastases result in significant pain and can lead to kyphosis and sagittal imbalance. Non-operative treatment can result in deformity and continued pain, and large surgical procedures have significant morbidity. Percutaneous cement augmentation (kyphoplasty and vertebroplasty) are minimally invasive techniques that can improve pain in these patients. Kyphoplasty also has the potential to provide mild deformity correction in addition to fracture stabilization.

Methods: Study participants were patients with biopsy-proven multiple myeloma presenting with compression fracture treated with kyphoplasty. Data were compiled from patient charts, pre- and postoperative radiographs. Patient self-reported functional status were obtained through the use of the Oswestry Disability Index (ODI). The degree of vertebral body collapse and deformity was evaluated using the method of Genant and analyzed using paired Student's t-test.

Results: Thirty-two consecutive patients who underwent kyphoplasty at a total of 76 levels for myelomatous vertebral compression fractures were identified. Sixteen fractures were at the thoracolumbar junction. Mean age was 64.3 years. Average Genant grade for involved levels improved from 1.9 preoperative to 1.53 postoperative, which was statistically significant (P<0.0001). Postoperative ODI score was obtained at a mean of 24 months, with a mean of 29.6%. Complications occurred in 12 (37.5%) patients, all consisting of minimal intraoperative cement extravasation without clinical sequelae. No changes in neurologic status were observed. Average hospital stay was 1.34 days post-procedure.

Conclusions: Kyphoplasty for vertebral compression fractures due to multiple myeloma is a safe and effective procedure that can lead to pain relief and vertebral height restoration.

(C) 2014 by Lippincott Williams & Wilkins, Inc.

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