Surgical Intervention for Patients with Multiple Myeloma with Involvement of the Spine

Surgery may be effective for patients with multiple myeloma (MM) with symptomatic involvement of the spine (SIS) who present with rapid neurological deterioration, according to a study published in the International Journal of Spine Surgery. 

In this retrospective analysis, researchers assessed 350 patients with MM over a period of 12 years (2006-2018); 24 patients were surgically treated for SIS. Researchers collated data on demographics, comorbidities, surgical indications, and outcomes and evaluated any factors associated with postoperative complications and overall survival (OS).

The researchers noted that clinical presentation at admission included pain (88%), sensory and/or motor deficit (67%), and bowel/bladder dysfunction (25%). They observed symptomatic pathological fractures in 33% of patients.

According to the results, most patients experienced both short- and long-term reduction in pain following surgery. The researchers noted that neurological deterioration during hospital stay, especially in the presence of motor deficit and/or bowel/bladder dysfunction, significantly reduced OS.

“Sudden-onset neurological deterioration had led predominantly to surgery. We have achieved good short- and long-term pain reduction. Surgery is a valuable option for [patients with] MM with SIS who present with rapid neurological deterioration with or without spinal cord compression and/or mechanical instability,” the researchers concluded.