Percutaneous Vertebroplasty for Pathological Vertebral Compression Fractures Secondary to Multiple Myeloma--Medium-Term and Long-Term Assessment of Pain Relief and Quality of Life.

Abstract

In patients with multiple myeloma (MM) there is ahigh risk of compression fractures of the spine. In the majority of cases, the method of treatment is percutaneous vertebroplasty (PV) or kyphoplasty (PK). The number of studies verifying their efficacy in MM is still relatively small. The aim of this study has been to assess medium- and long-term pain relief as well as improvement in the quality of life (QL) after PV in MM cases. There was aprospective group of 34 MM cases in which atotal of 131 vertebral bodies were augmented by means of PV. It was possible to follow up 22patients who agreed to take part in the assessment. Their level of daily activity and the level of pain were assessed using the Oswestry Back Pain scale and avisual analogue scale (VAS) before PV and at alater date (medium-term follow up was amean of 10months after the last operation). Five out of eight cases in which 4.5-5years had elapsed since the first PV were tested again (long-term follow-up). Relief of pain and improvement of QL, assessed amean of 10months after PV, proved to be statistically significant. On the average, pain decreased by 4.7 points as measured on the VAS scale and the average improvement in the QL measured on the Oswestry scale was 27.7%. There were no neurological or general complications. After 4.5-5years, there has not been any significant change in the level of pain relief or the improvement in the QL in the 5cases in which long-term assessment was possible. In MM cases, PV is asimple, effective and safe method for the treatment of vertebral infiltration and compression fractures, giving permanent long-term pain relief and concomitant improvement in the QL.