A group of Italian researchers found that vertebroplasty provides durable pain relief for multiple myeloma patients with spinal compression fractures. In addition, the procedure reduced the patients’ need for pain-relieving medications and back braces.
At least 70 percent of multiple myeloma patients suffer from bone disease, which is characterized by bone pain, fractures, and elevated calcium levels. Patients frequently experience compression fractures in the spine, which may cause back pain, partial paralysis of limbs, decreased sensation, and poor urinary control.
Researchers are currently evaluating the success of treating spinal compression fractures with a procedure called vertebroplasty. During this procedure, doctors inject acrylic cement into the patient’s collapsed vertebrae. Although vertebroplasty has been shown to improve patient back pain and general quality of life, researchers have yet to determine the procedure’s long-term effects in multiple myeloma patients.
In their study, a group of Italian researchers completed a prospective analysis of 625 vertebroplasty procedures performed on 106 myeloma patients from 2002 to 2009. All patients had at least 12 months of follow-up. The median follow-up time was 28 months.
The researchers found that at follow-up, patient pain had decreased significantly compared to prior to surgery. On a scale of 1 to 10, patients ranked their pain level at an average value of 9 prior to surgery. After surgery, the pain level decreased to an average value of 1.
The level of disability also decreased significantly after surgery. On a scale of 0 percent (no disability) to 100 percent (bed bound), the median pretreatment disability level was 82 percent. After surgery, the median disability level decreased to 7 percent, with 26 percent of patients reporting no disability.
All of the patients were taking pain-relieving medications prior to surgery; however, following the procedure, 51 percent of patients no longer needed these medications and the majority of other patients were able to lower the medication dose required for pain management.
Before the procedure, 76 percent of patients wore an orthopedic brace to assist with back pain. After treatment, only 14 percent still required the brace.
Cement leakage, the most common complication of vertebroplasty, occurred in 23 percent of cases.
During follow-up, 15 percent of patients reported new back pain, which was later confirmed with x-rays and MRI to be new spinal compression fractures due to disease progression. These patients all received a second vertebroplasty, which successfully treated the new spinal fractures.
For more information about this study, please refer to the study in the journal Cardiovascular and Interventional Radiology (abstract).