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73. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Griechischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

29.05. - 01.06.2022, Köln

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Management of vertebral column lesions in multiple Myeloma patients – a two-centre experience of 450 cases

Behandlung von Wirbelsäulenläsionen bei Patienten mit Multiplem Myelom – eine bi-zentrische Serie mit 450 Fällen

Meeting Abstract

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  • presenting/speaker Vanessa Hubertus - Charité – Universitätsmedizin Berlin, Klinik für Neurochirurgie, Berlin, Deutschland
  • Martin Stangenberg - Universitätsklinikum Hamburg-Eppendorf, Traumatologie und Orthopädie, Hamburg, Deutschland
  • Lennart Viezens - Universitätsklinikum Hamburg-Eppendorf, Traumatologie und Orthopädie, Hamburg, Deutschland
  • Sebastian Schulz - Universitätsklinikum Hamburg-Eppendorf, Traumatologie und Orthopädie, Hamburg, Deutschland
  • Caroline von Bassenheim - Charité – Universitätsmedizin Berlin, Klinik für Neurochirurgie, Berlin, Deutschland
  • Peter Vajkoczy - Universitätsklinikum Hamburg, Berlin, Deutschland
  • Marc Dreimann - Universitätsklinikum Hamburg-Eppendorf, Traumatologie und Orthopädie, Hamburg, Deutschland
  • Julia Sophie Onken - Charité – Universitätsmedizin Berlin, Klinik für Neurochirurgie, Berlin, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 73. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Griechischen Gesellschaft für Neurochirurgie. Köln, 29.05.-01.06.2022. Düsseldorf: German Medical Science GMS Publishing House; 2022. DocV229

doi: 10.3205/22dgnc221, urn:nbn:de:0183-22dgnc2218

Veröffentlicht: 25. Mai 2022

© 2022 Hubertus et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.

Gliederung

Text

Objective: Fifty percent of Multiple Myeloma (MM) patients suffer from vertebral column lesions. Indications for spine surgery are made with restraint because of an allegedly high complication rate. Structured data assessing indications, strategies, and optimal timing of spine surgery is lacking. The aim of this study is to assess treatment algorithms and safety of different treatment strategies.

Methods: Patients with vertebral column lesions due to MM were enrolled at two tertiary academic oncological centers between 2005 – 2020. Epidemiological, clinical, radiological, oncological, surgical and outcome data were assessed. The clinical course and spinal instability neoplastic score (SINS) of every vertebral lesion was assessed in conservatively and surgically treated patients.

Results: A total of 450 patients with 3621 vertebral column lesions were included. 68% of the patients received surgery due to pain (73%) and spinal instability (68%). Most patients (76%) received spine surgery within the first year of MM diagnosis, 24% were subjected to surgery 1-10 years after diagnosis of the vertebral lesion. 147 (33%) were treated conservatively, although 81% of these patients presented with a SINS >6 and 11% with neurological deficits. In the surgically treated group, 65% received instrumented spine surgery and 35% cement augmentation. Overall surgical complication rate was 7%. SINS did not correlate with the surgical procedure applied.

Conclusion: With this study, we show that there is no standardized procedure defined for the treatment of vertebral lesions in MM patients. Although instrumented spine surgery can be applied with acceptable complication rates compared to data from metastatic spine diseases, prospective observational studies are needed to generate robust data on diagnostic criteria, optimal timing and technique of surgical intervention considering patient reported outcome measures.

Figure 1 [Fig. 1]