Vertebroplasty Relieves Pain And Restores Mobility In Myeloma-Related Spinal Fractures, Study Finds
A recent study published in the journal Neurological Sciences determined that injecting bone cement into fracture sites in the spine, a procedure called vertebroplasty, leads to fast pain relief and restored mobility in multiple myeloma patients.
Myeloma cells accelerate processes that degrade bone, resulting in bone lesions and fractures. Spinal fractures, in particular, are a common complication associated with multiple myeloma and can leave patients unable to walk. Treatment options include radiation therapy, medication, and a minimally invasive procedure called vertebroplasty (for further description, see related Beacon article).
In the study, researchers looked back at the recovery data of 11 patients, all of whom had undergone at least one vertebroplasty procedure at the Instituto Clinico Humanitas, a medical institution in Italy, over a two-year period. Three patients received an additional vertebroplasty later on, bringing the total number of procedures performed to 14. Doctors examined the procedure’s effectiveness and safety.
Despite the aid of medication and bed rest, all 11 patients still experienced pain and on a scale of 1 to 10, ranked their pain at an average value of 7 prior to surgery. After surgery, patient pain decreased to an average value of 2.
After 11 of the 14 procedures (79 percent), patients experienced pain relief almost immediately. The other three procedures (21 percent) required 24 to 36 hours for pain relief to occur. In all instances, patients were discharged two days after the treatment.
Of the eight patients who initially needed orthopedic devices to walk, five patients (63 percent) no longer required the aids two weeks after treatment. Two of the three patients who needed walking aids after surgery had initially been wheelchair-bound.
Pain relief remained consistent over follow-up periods ranging from 1 day to 25 months. However, three patients developed fractures at a new site in the spine and required a second vertebroplasty. In three procedures (21 percent), the bone cement leaked into nearby spaces in the spinal column, but the leaks were noted and repaired during surgery.
Leakage is the most common complication of vertebroplasty and can have serious implications if the cement travels into the spinal canal, home to the spinal cord. However, the risk of such a complication ranges from one to three percent.
Because patients experienced rapid and sustained pain relief and many no longer needed walking devices or medication, researchers described the study results as “excellent.” They concluded that vertebroplasty is an effective procedure in treating spinal fractures because it is relatively non-invasive, relieves pain rapidly, and has a low rate of complication. They also speculated that the surgery may be used to prevent vertebrae fractures in the future.
For more information, please see the journal Neurological Sciences (abstract).
Related Articles:
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- Stem Cell Transplantation May Be Underutilized In Multiple Myeloma Patients In Their 80s
- Common Measures Of Heart And Blood Vessel Health May Predict Risk Of Heart-Related Side Effects During Treatment With Kyprolis
- Eyelid-Related Complications Of Velcade Therapy: New Insights And Recommendations
Another perspective:
Radiation therapy on a plasmacytoma at L-5 began as outpatient.
Day 2 patient is immobilized by pain and hospitalized for remaining 13 treatments.
Compression fracture seems to continue, patient spends three months in hospital trying to reduce pain and regain mobility - about two months into that time patient receives "successful" kyphoplasty - but the pain still yo-yos, finally patient goes home with brace but seems stalled out on rehab, by pain. Doctors won't treat myeloma until pain is under control. Visit to Mayo Clinic. Visit to University of Iowa Ortho dept, received a handout on the value of spinal fusion BEFORE radiation in preventing this continued cascade of compression fractures. Kyphoplasty was, in retrospect, too little too late.
Patient has rods implanted from L-5 to T-11. Rehab is easier than prior rehab, even given the surgery and generally weakened condition. Patient regains mobility without brace, reduces pain meds to zero (other than for peripheral neuropathy in toes and feet, possibly result of MM, of spinal compression, or of drugs to treat MM). Patient is finally able to receive treatment for multiple myeloma.