ORIGINAL ARTICLE   

Journal of Neurosurgical Sciences 2018 February;62(1):10-5

DOI: 10.23736/S0390-5616.16.03470-6

Copyright © 2015 EDIZIONI MINERVA MEDICA

language: English

Surgery for vertebral involvement in multiple myeloma

Pasquale DONNARUMMA ¹ ✉, Roberto TARANTINO ¹, Marika RULLO ², Adele GRISARO ¹, Maria T. PETRUCCI ³, Antonio SANTORO ¹, Roberto DELFINI ¹

¹ Department of Neurology and Psychiatry, Division of Neurosurgery, “Sapienza” University of Rome, Rome, Italy; ² Department of Psychology of Developmental and Socialization Processes, “Sapienza” University of Rome, Rome, Italy; ³ Department of Hematology, “Sapienza” University of Rome, Rome, Italy

BACKGROUND: To evaluate the results of surgery for vertebral involvement in multiple myeloma (MM) following the introduction of the new chemotherapy in 2006.
METHODS: Retrospective cohort study evaluating the patients with MM vertebral lesions from January 2006 to January 2014. Outcomes were based upon participation in ODI and EQ-5D. Statistical interpretation of the data was performed with SPSS version 19 software (SPSS Inc, Chicago, IL, USA).
RESULTS: One hundred twenty patients affected by MM were potentially eligible for recruitment. About 1/3 patients needed an operation for vertebral involvement. The disability was mainly related to the number of vertebrae affected by MM. No difference in disability and quality of life was observed between operated and non-operated patients, according to age, levels, and follow-up. The operated patients with a Thoracic location reported lower disability and higher quality of life than non-operated patients. Non-operated patients with one or two vertebrae affected reported lower levels of quality of life.
CONCLUSIONS: When a spinal column involvement occurs, the probability of undergoing surgery is about 40%. Operated patients show a moderate disability and the increased tendency is related to the number of vertebrae involved. The quality of life is middle in average and middle-high in patients operated for thoracic lesions. Nowadays the spinal surgeon must have a perspective view about MM vertebral lesions, evaluating the stability of the spine, the presence of deformity, the risk of vertebral fractures and the presence of drug resistant pain, that deteriorate the disability and the quality of life related to the underlying disease.

KEY WORDS: Multiple myeloma - Spinal neoplasms - Immunologic factors - Proteasome inhibitors - Quality of life - Hematology