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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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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

View larger version (73K): [in this window] [in a new window]   Fig 1. Sagittal T1 MR imaging demonstrating fracture types. Stars indicate treated fractures. A, Type 1 fracture, considered probably osteoporotic in nature. Areas of preserved, high T1 signal intensity within the fractured vertebral body, without focal intravertebral lesion and no evidence for pedicle involvement or epidural or paraspinal disease (not shown). B, Type 2 fracture, indeterminate for underlying lesions. Diffusely low signal intensity marrow throughout the spine. No focal lesion or epidural or paraspinal lesion within the treated vertebral body. C, Type 3 fracture, with clear evidence for myelomatous lesion within the treated vertebral body.

View larger version (26K): [in this window] [in a new window]   Fig 2. Treated and affected levels. Vertebral level frequency histograms of 114 treated vertebral levels (A) and 216 affected vertebral levels (B) in the 67 patients composing the myeloma study population. Diffuse myeloma involvement (>10 vertebral bodies) was not included in this histogram.

View larger version (16K): [in this window] [in a new window]   Fig 3. Time to treatment. Time to treatment of myeloma study participants is shown as a function of a frequency histogram with each bin representing a 4-month period.

View larger version (17K): [in this window] [in a new window]   Fig 4. Objective clinical outcome scores over time. Mean (± SD) RDQ and analog pain scale (pain with rest and activity) scores are shown preoperatively (baseline), postoperatively, and 1 week, 1 month, 6 months, and 1 year after vertebroplasty.