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AJNR - American Journal of Neuroradiology

Published ahead of print on January 17, 2008
doi: 10.3174/ajnr.A0918

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American Journal of Neuroradiology 29:642-648, April 2008
© 2008 American Society of Neuroradiology

SPINE

Vertebroplasty in Multiple Myeloma: Outcomes in a Large Patient Series

R.J. McDonald^a,b, A.T. Trout^c, L.A. Gray^d, A. Dispenzieri^b,e, K.R. Thielen^b,d and D.F. Kallmes^b,d

^a Medical Scientist Training Program, Mayo Clinic, Rochester, Minn
^b Mayo Clinic College of Medicine, Mayo Clinic, Rochester, Minn
^c Department of Radiology, University of Michigan, Ann Arbor, Mich
^d Department of Radiology, Mayo Clinic, Rochester, Minn
^e Department of Hematology, Mayo Clinic, Rochester, Minn

Please address correspondence to David F. Kallmes, Mayo Clinic, Department of Radiology, 200 1st St SW, Rochester, MN 55905; e-mail: kallmes.david{at}mayo.edu

BACKGROUND AND PURPOSE: Despite the literature supporting the efficacy of vertebroplasty for treatment of osteoporotic vertebral compression fractures, few reports exist documenting its use in the treatment of compression fractures in multiple myeloma patients. Accordingly, we sought to characterize the imaging characteristics, clinical course, and outcomes in myeloma patients treated with vertebroplasty.

MATERIALS AND METHODS: We performed a retrospective review of clinical outcome data from 67 multiple myeloma patients treated with vertebroplasty since October 2000. Quantitative outcome data including the Roland Morris Disability Questionnaire (RDQ) and Visual Analog Scales for pain and qualitative outcome data (self-reported pain, mobility, and narcotic use) were collected preoperatively, immediately after vertebroplasty, and at 1 week, 1 month, 6 months, and 1 year after treatment.

RESULTS: Significant improvements in all of the outcome measures were observed postoperatively and throughout the duration of follow-up. Quantitative outcome measures (RDQ, analog pain scale 0–10, with rest and activity) improved by 11.0 (48%; P < .0001), 2.7 (25%; P < .001), and 5.3 (48%; P < .0001) points, respectively, with persistent improvement at 1 year (P < .01; P < .03; P < .001). Eighty-two percent and 89% of patients experienced a significant improvement in subjective rest pain and activity pain, respectively. Subjective scores achieved durable improvements, with 65% of patients requiring fewer narcotics after vertebroplasty and 70% having improved mobility.

CONCLUSION: Vertebroplasty provides significant and durable pain relief for patients with intractable spinal pain secondary to compression fractures resulting from multiple myeloma.