Surgical Intervention for Spinal Lesions Due to Multiple Myeloma: A Case Report

Abstract

Vertebral disease is a main source of morbidity (MM) in individuals with multiple myeloma. The effects of associated osteolytic lesions and vertebral fractures on severe pain, functional limits, spinal deformity, and cord compression are well recognized. Systemic therapy, radiation, cementoplasty (vertebroplasty/kyphoplasty), and radiofrequency ablation are now available therapeutic options for severe MM spinal pain. We here reported a case of a 45-year-old male who had complained of progressive symptoms of pathological spine fractures. He had been examined and investigated for the cause of lytic lesions and found to have multiple fractures in the spine. A computed tomography (CT) revealed multiple osteolytic lesions noted in the thoracolumbar spine, ribs (bilaterally), and pelvic bones. Magnetic resonance imaging (MRI) showed a compression fracture of the T8 vertebral body with evidence of retro-bulging and a spinal canal narrowing. However, there was no evidence of spinal cord abnormal signal intensity. T2 weighted image (T2WI) keeping with edema is noted. A surgical intervention fixed the fracture and improved the quality of life. Vertebroplasty, a minimally invasive procedure, as a treatment option for vertebral lesions and pathologic fractures in the MM, showed good clinical improvement in the patient.

Lesions of the spinal cord caused by multiple myeloma: A systematic review and meta-analysis regarding the neurosurgical aspects of patient management

“…According to the authors, it should be noted that acute SCC requires emergency medical care within 24 h after diagnosis. [ 11 12 13 ] The goals of treatment are to prevent further neurological damage, preserve motor function, and relieve pain. All patients are given a loading dose of corticosteroids as first-line therapy.…”

Vertebral Primary Bone Lesions: Review of Management Options

“…Vertebral primary bone lesions have long presented a challenge to spinal care specialists. Not only is there a wide variety of spinal lesions described in the literature, the treatment of these tumors, benign or otherwise, is often complex and complicated by factors such as neural compression [ 1 ]. Vertebral lesions are also frequently found incidentally when the patient presents with back pain, weakness, or myelopathy, and if management is delayed, vertebral lesions can lead to a complete loss of sensory and motor function [ 2 ].…”

“…A plethora of interventions exists in the context of vertebral tumors. Yet, while much of the literature describes spinal lesions and corrective measures for specific tumors, there is a paucity of studies available that discuss these different lesion types and explain general guidelines for their treatment [ 1 , 11 , 12 ]. Most reviews on vertebral lesions are based on a series of case reports, and indeed there is little literature generally overviewing these tumors.…”