INTRODUCTION: multiple myeloma is a malignant neoplasm of monoclonal and diffuse proliferation of plasma cells that typically involves the bone marrow. The spine is one of the most commonly affected sites. It may cause severe intractable pain, spinal instability, or neurological complications. The surgical treatment for multiple myeloma includes open decompressive surgery and arthrodesis with or without stabilization. The medical literature presents little researches focused on clinical outcome with regard to pain and neurological improvement. OBJECTIVE: to evaluate clinical outcomes in patients surgically treated for multiple myeloma of the spine. METHODS: a total of 16 consecutive patients who underwent spinal column decompression for multiple myeloma with or without stabilization were retrospectively studied. The local extent of tumor was graded based on Tomita et al. classification. The patients were assessed with regard to pain and neurological improvement according to Frankel's classification. RESULTS: the four patients with normal examination (Frankel E) remained without neurologic deficit in the postoperative period. Two Frankel D patients evolved to Frankel E. Two Frankel C patients evolved to improvement (Frankel D) and one Frankel C patient remained with the same status. Four Frankel B patients evolved to Frankel D after decompression. Two Frankel A patients (complete neurological deficit) also improved their neurological status (Frankel B and C), and one died in the immediate postoperative period. CONCLUSIONS: surgical treatment of spinal lesions due to myeloma presents good clinical outcome based on pain and neurological improvement in well selected cases.
Multiple myeloma; Spinal neoplasm; Treatment outcome
