SIR: Vertebroplasty brings pain relief to blood marrow cancer patients

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The minimally invasive treatment that that stabilizes collapsed vertebrae with the injection of medical-grade bone cement into the spine, vertebroplasty, can result in a reduction of pain, medication usage and disability in patients with multiple myeloma, according to researchers who presented their findings at the 35th Annual Society of Interventional Radiology's (SIR) scientific meeting in Tampa, Fla.

In patients with this type of blood marrow cancer that can cause bone deterioration of the vertebrae, interventional radiologists using imaging guidance to administer the cement into the spine can treat the commonly occurring vertebral compression fractures that occur frequently within this patient population, said Eren Erdem, MD, associate professor of radiology and neurosurgery and chief of interventional neuroradiology at the University of Arkansas for Medical Sciences in Little Rock.

“By reducing pain and improving mobility, vertebroplasty helps patients become better equipped to continue with their rigorous treatment for multiple myeloma," explained the researchers.

Erdem and colleagues recruited 792 patients--45 percent women with an average age of 63--with multiple myeloma and treated 2,715 non-osteoporotic vertebral compression fractures. Of the 2,715 fractures, 2,258 were treated with vertebroplasty and the remaining 457 fractures were treated by way of kyphoplasty, a procedure in which a balloon is placed in the vertebrae, inflated and then bone cement is applied.

Utilizing the 11-point visual analog scale to rate pain intensity, the researchers found that the average scores for patients dropped from seven to 2.7 during the course of the six-year study.  In addition, the authors noted that 37 percent of patients reported a decrease in medication usage, 62 percent experienced no change and 1 percent reported an increase in medication usage.

Moreover, said Erdem, 48 percent of patients reported an improvement in their post-procedural activity level and 83 percent would consider vertebroplasty or kyphoplasty again, if necessary.

"In our study, patients' pain from their spinal fractures was significantly reduced following vertebroplasty, resulting in about a 40 percent reduction in the use of narcotics for pain control," reported Erdem and colleagues.

While there have been other studies that have similarly reported the effectiveness of vertebroplasty in treating osteoporotic vertebral compression fractures, Erdem said.  “With 792 patients, this is the largest study to date in the treatment of compression fractures in multiple myeloma patients.”