Bone cement augmentation procedures for spinal pathologic fractures by multiple myeloma

Efficacy and safety of bone cement augmentations for spinal pathologic fractures relatedto multiple myeloma, and usefulness of radionuclide studies for surgical decision wereretrospectively evaluated. Forty eight vertebrae from 27 patients for bone cementaugmentation procedures and 48 vertebrae from 29 patients for conservative treatmentwere enrolled. Clinical results using visual analogue scale (VAS) and Oswestry disabilityindex (ODI), and radiologic results were assessed. For clinical decisions on treatment ofspinal pathologic fracture, bone scan or single photon emission computed tomographywas done for 20 patients who underwent surgery. Mean follow-up was 16.8 months. Interms of clinical results, immediate pain relief was superior in the operated group to that inthe conservative group. ODI, maintenance of vertebral height and local kyphotic angle atthe last follow-up were superior in the operated group in comparison to the conservativegroup. At one year follow-up, cumulative survival rate were 77.4% and 74.7% in theoperated and conservative groups, respectively (log rank test > 0.05). Leakage of bonecement was noted at 10 treated vertebrae. Bone cement augmentations presented shorttermpain relief for spinal pathologic fractures by myeloma with relative safety in highlyselected patients, and radionuclide imaging studies were useful for the surgical decision onthese procedures.