Vertebroplasty Relieves Pain For Multiple Myeloma Patients With Spinal Fractures
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).
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My question is: "Is there limited mobility with the cement?" My father is an MM patient and asked me to research this. He is wanting the surgery in the next couple of months.
My husband had this procedure, 8 months after a T8 vertebrae compression fracture. Eight months is too long after, but we had a great doctor who has done many of these on MM patients in Little Rock. In addition he did a nerve block while he was in there. Dave was able to immediately come off the opiates as a result of this procedure and last month he played his first 18 holes of golf successfully.
We have had none and as I mentioned my husband just played 18 holes of golf. That's a lot of swinging and twisting. He came home beaming with excitement that he was successful.
Great thank you so much. I appreciate the info!
I had a very good experience with vertebroplasty 6-1/2 years ago on T12, L1, and L3 five months after stem cell transplant. I was required to go off opiates prior to the procedure. It was a fairly simple experience done under sedation. I rested in bed afterward for several hours before discharge to home. Aside from a bit of soreness where the needle injected the cement, my back felt quite good immediately.
I still wonder how many years the cement will hold up, but so far so good. If I had it do again, I would look into kyphoplasty because it often brings back a bit of height that vertebroplasty does not.
Bob had no problems with the bone cement, but the Vertebroplasty (because of a Compression Fracture in the L1) did not stop his pain. The surgeon was not hopeful, prior to the procedure, that it would be a success.
Not until he had a Lumbar Radio Frequency Dennervation (Nerves Burned) did he begin to have less pain. He is still on some meds - but not nearly as much as before.
It might be worth consulting with a Pain Management Specialist.
My son had both a vertebroplasty and a balloon kyphoplasty procedure for vertebrae compression fractures 4 years ago. Both were performed as out-patient procedures and the pain relief was immediate. I understand that doctors at the University of Arkansas for Medical Sciences have a great deal of experience and expertise in these procedures and have had much success with them in the treatment of osteoporosis as well as multiple myeloma.
At diagnosis I was experiencing a great deal of pain due to many fractures, vertebral and otherwise. Kyphoplasties at T4, T11 and T12 (performed at UAMS in Little Rock) greatly reduced the pain. The procedures were done on an out-patient basis, recovery was quick and my quality of life has been significantly improved.
I have had kyphoplasty performed at the U of MI in Ann Arbor as a result of my spine suffering compression fractures from MM. I had 6 vertebre done and it has shored up my ability to remain quite mobile and do stuff like I used to prior to the stinkin' MM coming in and making a mess of my life.
I'm not 20 anymore, but like posted above, I feel much better than I did.
I had kyphoplasty 5 months ago. I have multiple compressed vertebrae and they were only able to do 5 in one sitting. My pain has gotten much better. I went from Fentanyl 100 down to 25 and have quite a bit of mobility. Unfortunately, I've gone from 5'10" down to around 5'3". I'm not sure how much of my pain/mobility problems are just due to the loss of height. It does take quite a bit of getting used to.
I am web searching for help for my husband who has a MM related tumor with lesions on his spine . He suffers terribly. Radiation will damage his bone marrow which he needs! After 6 months of velcade, our Dr is now recommending radiation where he was opposed before. The numbers are still at 60% cancer. Would this procedure be a consideration for him as pain relief ?
i would like to be able to send this article to my niece as my sister might have this disease and is currently in the hospital and awaiting diagnosis.
Hello Elizabeth,
We are very sorry to hear that your sister may have multiple myeloma.
We will send you the news alert for this article via email, which you can then forward on to your niece.
We wish your sister the very best.
Hello, My dad has been diagnosed with MM since 2003. He has done 2x velcade and radiation treatment. Now it came back again with spinal cord compression. Can someone help me the survival chance of my dad. He doesn't want to do another treatment.
Hello Liz,
We are very sorry to hear that your father relapsed.
You may want to post your question to our forums. That way, one of our medical advisors may be able to provide you with an answer.
Best wishes to your father.
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