Surgery Improves Pain and Quality of Life in Multiple Myeloma Patients with Symptomatic Osteolytic Spinal Lesions

Purpose: A prospective study that aims to present the functional outcome and the survival of 21 consecutive selected Multiple Myeloma (MM) patients who underwent 25 surgeries for symptomatic vertebral body osteolysis. Methods: 25 wide spectrum surgeries including percutaneous augmentation, hybrid fixation and circumferential decompression were performed for symptomatic vertebral body osteolysis in 21 selected patients with MM. Tomita osteolysis classification, Karnofsky disability scale, ASIA neurological impairment scale and VAS pain scale were used. Survival analysis was performed. Results: All patients were followed for a minimum of 6 months postoperatively. Karnofsky Index improved from 66%±20% preoperatively to 81.3%±15%, onemonth and 83%±10% one year postoperatively. VAS score significantly reduced in all patients from 7.08±2 preoperatively to 3.35±1.5 at the latest evaluation. One patient with ASIA grades D and 2 with ASIA grades C improved postoperatively to ASIA E. The one-year survival from index diagnosis was 85.2% (95% CI, 60.6% - 96.0%), while it dropped to 55.4% (29.4% - 75.1%) five-year postoperatively. Τhe one-year survival rate from index surgery was 65.9% (95% CI, 38.8% - 83.2%), and dropped to 33.5% (95% CI, 11.1% - 58.0%) five-years postoperatively. Conclusions: There are several modalities of surgery for symptomatic osteolytic vertebral body lesions in MM patients. Surgery was proved a safe procedure with few complications it reduced pain and improved quality of life. Together with hematological and radiation therapy it may increase the survival of MM patients.