Robert J. McDonald PhD, Presenter: Nothing to Disclose

Andrew Timothy Trout MD, Abstract Co-Author: Nothing to Disclose

Leigh A. Gray, Abstract Co-Author: Nothing to Disclose

Angela Dispenzieri MD, Abstract Co-Author: Nothing to Disclose

Kent Ronald Thielen MD, Abstract Co-Author: Nothing to Disclose

David Forrest Kallmes MD, Abstract Co-Author: Research support, ArthroCare Corporation

Percutaneous vertebroplasty (PV) is frequently applied to patients with multiple myeloma suffering from painful compression fractures. Surprisingly, the literature to support the application of PV in multiple myeloma patients is quite scant, with the largest series to date comprising only 16 patients. We describe an analysis of outcomes in 66 PV patients for painful malignant vertebral compression fractures.

A retrospective review was performed of 66 multiple myeloma patients initially treated with PV at 113 vertebral levels between October 2000 and February 2007. Outcomes were assessed using the Roland Morris Disability Questionnaire (RDQ) and visual analogue scales (VAS) (0-10) for pain at rest and with activity pre-operatively, immediately post-vertebroplasty and at 1 wk, 1 mo, 6 mo, and 1 yr post-VP. The Wilcoxon signed rank test was used for comparisons between outcome measures at the various follow up time points.

Prior to PV, mean scores (SD) were 19.5 (3.44), 3.9 (0.65) and 8.5 (0.35) for the RDQ and VAS measures of pain at rest and activity, respectively. RDQ scores significantly improved (p<0.0001) immediately following PV (median improvement of 11 pts, 95% CI: -7.7 to -14.3) and persisted at 6 months (p<0.0001 compared to pre-procedure scores) and 1 year (p<0.01 compared to pre-procedure scores) with no statistically significant differences in post-procedure scores. VAS for rest pain significantly improved following PV (p<0.01 post-op and p<0.001 1 wk after PV) with a median improvement of 2.7 points at 1 wk (95% CI: 1.7 to -3.7) and persisted at 6 mo (p<0.01 compared to pre-op score) and 1 yr (p<0.03 compared with pre-op score). VAS for activity pain significantly improved following vertebroplasty (p<0.0001, median 5.3 point improvement at 1 wk, 95% CI: -4.2 to -6.4) and remained improved at 6 mo (p<0.001) and 1 yr (p<0.001).

Vertebroplasty provides significant and durable pain relief for patients with intractable spinal pain secondary to compression fractures in patients with multiple myeloma.

Percutaneous vertebroplasty provides effective and durable pain relief to malignant compression fractures as a result of multiple myeloma.

McDonald, R, Trout, A, Gray, L, Dispenzieri, A, Thielen, K, Kallmes, D, Vertebroplasty in Multiple Myeloma: Outcomes in a Large Patient Series.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5010834.html