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Patients with multiple myeloma have less pain, more mobility after vertebroplasty
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An interventional radiology research team found that performing vertebroplasty for nonosteoporotic vertebral compression fractures in patients with multiple myeloma stabilized collapsed vertebrae while reducing pain, medication usage and disability.
“In our study, patients’ pain from their spinal fractures was significantly reduced following vertebroplasty, resulting in about a 40% reduction in the use of narcotics for pain control,” the senior author of the study Eren Erdem, MD, stated in a press release from the Society of Interventional Radiology (SIR).
Results of the study were recently presented at the SIR 35th Annual Meeting.
Erdem and colleagues at the University of Arkansas for Medical Science said that their work is the largest study of its kind. Over a 6-year period they treated 2,715 nonosteoporotic vertebral compression fractures (VCFs) in 792 patients with multiple myeloma.
Significant pain reduction
Researchers used the Visual Analog Scale to track changes in pain intensity and evaluated patients’ self-reported medication use and activity levels.
According to data included in the press release, after treatment patients’ average pain scores dropped from 7.0 to 2.7. The investigators also found that 37% of patients reported decreased medication usage compared to 62% who had no change, and 1% of patients who reported increased medicine use.
Nearly half of the patients had improved activity levels following vertebroplasty.
“By reducing pain and improving mobility, vertebroplasty helps patients become better equipped to continue with their rigorous treatment for multiple myeloma,” Erdem stated in the release.
- Reference:
Malak SF, Atherton M. Wood C, et al. Vertebral augmentation in the treatment of non-osteoporotic vertebral compression fractures in 792 patients with multiple myeloma. Paper #17. Presented at the SIR 35th Annual Scientific Meeting. March 13, 2010. Tampa, Fla.
Vertebral augmentation in the treatment of tumor is well known from the multicenter study and various other studies. In my biased opinion, a kyphoplasty-type of procedure is a superior and safer treatment option in vertebral augmentation than vertebroplasty.
In our study, balloon kyphoplasty led to a significant and sustained reduction of pain resulting in a significant functional improvement of the patients. In the radiological evaluation a significant restoration of vertebral height (P < .05) and reduction of the kyphotic angle (P < .05) could be achieved in the patients with multiple myeloma. The cement leakage rate is known to be higher in tumor augmentation and therefore procedures like balloon kyphoplasty should be the preferred procedure.
A new procedure, Serpentine Z-plasty (Spinal Ventures; Pinckney, Mich.), could be the ultimate solution in the management of tumors of the spine, as initial results show no leakage and excellent height restoration.
– Anand Agarwal, FRCS
Medway Maritime Hospital
Kent, United Kingdom
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