Surgical Treatment for Spinal Myeloma

Objective To investigate the indication,approach and results of the surgical treatment of spinal myeloma.Methods We made a retrospective analysis of cliniacal history and operation results of 19 patients with spinal myeloma.There were 11 males and 8 females with the average age of 62.4 years.13 cases were solitary myeloma and 6 were multiple myeloma.A total of 25 vertebrae were involved.The primary affected vertebrae were:thoracic vertebra in 15 cases,lumbar vertebra in 8 cases,cervical vertebra in 1 cases.According to the physical condition of patients and the destruction of vertebra,minimally invasive operations(including percutaneous vertebroplasty and percutaneous kyphoplasty)or open operations(including anterior,posterior or combined approach operations for the excision of focus)were recommended.Results The mean follow-up time were 24.3 months(range,3～42 months).One patient died of renal failure.Local recurrence were found in 3 cases during the follow-up time.Two weeks after operation,the mean VAS score of all the 19 patients decreased to 2.73(range,1～4),which was 7.84(range,6～9) preoperatively.According to Kamofsky score,with paried T test,the difference of patients′ quality of life between preoperation and half a year after operation was statistically significant(P0.01).Conclusion Surgical interruption is a feasible and effective method to improve the quality of life for the spinal myeloma patients with neurological deficit and intractable pain.