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Beitragstitel Surgical Management of Multiple Myeloma with Symptomatic Involvement of the Spine
Beitragscode P021
Autoren
  1. Helena Milavec Schuthess Clinic Vortragender
  2. Nivetha Ravikumar Department of Orthopaedic Surgery, National University Health System (NUHS) – Tower Block, Level 11, 1E Kent Ridge Road, Singapore 119228
  3. Nicholas L. Syn Yong Loo Lin School of Medicine, National University of Singapore, Singapore
  4. Cinnie Y. Soekojo Department of Haematology-Oncology, National University Health System – Tower Block, Level 10, 1E Kent Ridge Road, Singapore 119228
  5. Chng Wee J. Department of Haematology-Oncology, National University Health System – Tower Block, Level 10, 1E Kent Ridge Road, Singapore 119228
  6. Naresh Kumar Department of Orthopaedic Surgery, National University Health System (NUHS) – Tower Block, Level 11, 1E Kent Ridge Road, Singapore 119228
Präsentationsform Poster
Themengebiete
  • A03 - Wirbelsäule
Abstract Introduction
Multiple myeloma(MM) is the most frequent primary malignancy of the spine, resulting in osteolytic lesions which may lead to spinal instability, pathologic fractures, and spinal cord compression(SCC).

Aim
To investigate the clinical presentation, surgical indications and outcomes, complications, survival and its influencing factors in surgically treated MM patients with symptomatic involvement of the spine(SIS).

Methods
Out of 350 MM patients treated at our institution from 2006-2018, we identified 24 patients surgically treated for SIS. A retrospective analysis of prospectively-collected data was done on demographics, clinical presentation, comorbidities, surgical indications and outcomes as well as factors predisposing to postoperative complications and survival.

Results
The median follow-up duration was 85 months; median overall survival(OS) was 50 months. Clinical presentation at admission included pain(88%), sensory and/or motor deficit(67%) and bowel/bladder dysfunction(25%). Symptomatic pathological fractures occurred in 33%. Predominant surgical indication was rapid neurological deterioration±SCC, followed by mechanical instability. There were 21% patients with surgical-related complications(<3 months). Surgical-site infections occurred in 17%, without any obvious predisposing factors. Neurological deterioration, especially in the presence of motor deficit and/or bowel/bladder dysfunction, significantly reduced OS.

Conclusions
In MM patients, rapid neurological deterioration was identified to be the predominant surgical indication. We have achieved good short- and long-term pain reduction. Surgery is a valuable option for MM patients with SIS who present with rapid neurological deterioration±SCC and/or mechanical instability.