Diagnosis and surgical therapy of plasma cell neoplasia of the spine

Rehák, S; Maisnar, Vladimír; Málek, Václav; Česák, Tomáš; Ryška, Pavel; Bartos, M; Talab, R

doi:10.4149/neo_2009_01_84

Cited by 7 publications

(4 citation statements)

References 6 publications

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“…Thus, surgical treatment (often combined with radiotherapy) appears particularly effective in restoring deficits and the ambulatory capacity in this setting. Of note, we also observed that totally bedridden patients have a poor survival, corroborating similar data by Rehak et al, 14 which obviously reflects the negative effect of reduced mobility and associated morbidity in the general condition of the patient.…”

Section: Discussionsupporting

confidence: 92%

“…[9][10][11][12] However, the outcome of surgical treatment of patients with radiosensitive hematological malignancies is largely unknown, because they were mostly excluded from the aforementioned prospective studies and the only data are derived from small retrospective cohorts. 13,14 We retrospectively reviewed prospectively collected data of 50 consecutive patients surgically treated for MSCC due to lymphoma or myeloma between July 1993 and December 2012, and we documented the treatment outcomes.…”

Section: Introductionmentioning

confidence: 99%

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Outcome of Surgical Treatment for Spinal Cord Compression in Patients With Hematological Malignancy

Tsagozis

Bauer

2019

Int J Spine Surg

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Background: We investigated the outcome of surgical treatment of patients with radiosensitive hematological malignancies presenting with spinal cord compression. Methods: Retrospective review of 50 patients who had treatment between 1993 and 2012. Results: The neurological outcome was favorable in 35 patients, stable in 12, whereas 3 patients deteriorated. Decompression within 48 hours from referral was associated with a superior neurological recovery (P ¼ .001). Complications were noted in 11 patients, and 6 of these underwent secondary surgery. Early (30-day) mortality was 8%. Radiotherapy was associated with increased incidence of complications (v 2 ¼ 0.009). Patients who had low blood hemoglobin preoperatively as well as those who remained totally bedridden postoperatively had an inferior overall survival rate (P , .001). Conclusion: Patients with cord compression from hematological malignancy benefit from early surgical decompression. There is an inherent high risk for complications, which increases further if radiotherapy is given. Patients failing to ambulate after surgery have a poor prognosis.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Outcome of Surgical Treatment for Spinal Cord Compression in Patients With Hematological Malignancy

Tsagozis

Bauer

2019

Int J Spine Surg

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“…The results of such treatment are not good, however: in patients who cannot move prior to surgery, only 38% report a significant improvement in their neurological status, while 62% of all patients report diminished mobility, notwithstanding decompression of the spinal cord [13].…”

Section: Discussionmentioning

confidence: 97%

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

Jurczyszyn

Banach²,

Godlewski³

et al. 2015

Adv Clin Exp Med

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Background. In patients with multiple myeloma (MM) there is a high 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. Objectives. 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. Material and Methods. There was a prospective group of 34 MM cases in which a total of 131 vertebral bodies were augmented by means of PV. It was possible to follow up 22 patients 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 a visual analogue scale (VAS) before PV and at a later date (medium-term follow up was a mean of 10 months after the last operation). Five out of eight cases in which 4.5-5 years had elapsed since the first PV were tested again (long-term follow-up). Results. Relief of pain and improvement of QL, assessed a mean of 10 months 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 4.5-5 years, there has not been any significant change in the level of pain relief or the improvement in the QL in the 5 cases in which long-term assessment was possible. Conclusions. In MM cases, PV is a simple, 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 (Adv Clin Exp Med 2015, 24, 4, 651-656).

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“…However, there are studies showing that complications of radiotherapy are less than surgery (7,8,9). However, Rehak et al (10) suggested that the surgical approach for these tumors should be considered for long survival.…”

Section: Discussionmentioning

confidence: 99%

Omurilik Basısı Nedeniyle Dekompresyon Uygulanan Multipl Miyelom Olgularının Değerlendirilmesi

Eren¹,

Güleç²,

Güzey³

et al. 2020

Osmangazi̇ Journal of Medicine

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Multiple myeloma accounts for 5-10% of all cancers associated with spinal cord compression. In this study, the surgical results of patients with multiple myeloma operated for spinal epidural compression were evaluated. Between 2011 and 2017, twenty-one patients were operated by posterior decompression for spinal cord compression, whose pathological diagnosis was multiple myeloma in our hospital's neurosurgery clinic included in the study. Demographic, clinical and radiological features of the patients and their status after surgery were examined. The mean age of the 21 patients was 62.6 ± 9.3. Thirteen patients were male and 8 were female. When the chain isotype was found in protein electrophoresis, the maximum IgG (52.4%) was present. The mean Karnofsky performance of the patients was 46.2 ± 17.7. Significant improvement was observed in the postoperative motor strength of the patients (p = 0.0001). In addition, postoperative pain-VAS scores-was significantly reduced (p = 0.0001). 90% of the patients were operated under emergency conditions. The number of patients who were operated stabilization with decompression was 5 (23.8%). When the radiological data were analyzed, the mean amount of compression in the operated vertebrae was 33.1% and the mean shrinkage rate of the tumor was 65.4%. Although spinal canal narrowing was observed in all patients, compression fracture was present in 16 patients (76.2%). The mean follow-up period was 22.3 months. During the follow-up period, 9 patients died, 5 of them were in the first year. Postoperative complications were wound infection in 2 patients, chronic renal failure in 1 patient and bilateral pleural effusion in 1 patient. Surgical treatment should be the first option if there is a progressive neurological deficit in patients with spinal cord compression due to multiple myeloma. With surgical treatment, decompression of the spinal cord compression, pain control and stabilization can be performed.

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Diagnosis and surgical therapy of plasma cell neoplasia of the spine

Cited by 7 publications

References 6 publications

Outcome of Surgical Treatment for Spinal Cord Compression in Patients With Hematological Malignancy

Outcome of Surgical Treatment for Spinal Cord Compression in Patients With Hematological Malignancy

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

Omurilik Basısı Nedeniyle Dekompresyon Uygulanan Multipl Miyelom Olgularının Değerlendirilmesi

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