MULTIPLE MYELOMA OF THE SPINE: SURVIVAL, COMPLICATIONS, AND NEUROLOGICAL STATUS AFTER SURGICAL TREATMENT

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Abstract

Purpose – to evaluate the survival, neurological status, and complications after surgical management of patients with multiple myeloma of the spine. Materials and methods. A retrospective study of 44 patients with multiple myeloma of the spine operated in Vreden Institute of Traumatology and Orthopedics was held in the period between 2000 and 2015. Patients underwent decompressive surgery with additional spinal instrumentation. following parameters were evaluated: demographic data, pain intensity, neurological deficit, survival, and complications after surgery. Results. Overall results showed efficiency of surgical management of spinal instability and neurological compromise due to multiple myeloma of the spine. The mean postoperative survival time was 63 months. A significant improvement in VAS scale and neurological function was observed in the study population after surgery. Postoperative VAS was 7.1 scores compared with 3.6 scores preoperatively (p = 0.021). Twenty nine of 31 patients improved their neurological status. Poor life expectancy was associated with neurological deficit both before and after surgery (p<0.0001). There were 28 postoperative complications. Most frequent complications were deep wound infection and adjacent degenerative disease. There was no survival difference in cohorts with and without complications (p = 0.942).> <0.0001). There were 28 postoperative complications. Most frequent complications were deep wound infection and adjacent degenerative disease. There was no survival difference in cohorts with and without complications (p = 0.942). Conclusion. Decompression surgery with additional instrumentation significantly decrease pain intensity and improve neurological function in selected patients affected by spinal myeloma with spinal instability. Severe neurological deficit influence on survival both before and after surgery. Survival did not depend on complications.

About the authors

N. S. Zaborovskii

Vreden russian research Institute of Traumatology and orthopedics 8, ul. Akad. Baykova, St. Petersburg, 195427, Russia

Author for correspondence.
Email: n.zaborovskii@yandex.ru

Graduate Student

Russian Federation

D. A. Ptashnikov

Vreden russian research Institute of Traumatology and orthopedics 8, ul. Akad. Baykova, St. Petersburg, 195427, russia
Mechnikov North Western State Medical University 41, Kirochnaya ul., St. Petersburg, 191015, russia

Email: n.zaborovskii@yandex.ru

Dr. Sci. (Med) Professor Head of Spine Surgery and Oncology Department, Vreden Russian Research Institute of Traumatology and Orthopedics; Head of Traumatology and Orthopedics Department, Mechnikov North Western State Medical University

D. A. Mikhaylov

Vreden russian research Institute of Traumatology and orthopedics 8, ul. Akad. Baykova, St. Petersburg, 195427, russia

Email: n.zaborovskii@yandex.ru

Cand. Sci. (Med) Neurosurgeon at Spine Surgery and Oncology Department

O. A. Smekalenkov

Vreden russian research Institute of Traumatology and orthopedics 8, ul. Akad. Baykova, St. Petersburg, 195427, russia

Email: n.zaborovskii@yandex.ru

Cand. Sci. (Med) Neurosurgeon at Spine Surgery and Oncology Department

S. V. Masevnin

Vreden russian research Institute of Traumatology and orthopedics 8, ul. Akad. Baykova, St. Petersburg, 195427, russia

Email: n.zaborovskii@yandex.ru

Orthopedic Surgeon at Spine Surgery and Oncology Department

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