[Surgical treatment of spinal myeloma, report of 19 cases].

Zhonghua Yi Xue Za Zhi

Department Of Orthopaedics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.

Published: August 2002

Objectives: To discuss the indications for surgical procedures of spinal myeloma.

Methods: A retrospective analysis was made of the data of operation results of Nineteen patients with spinal myeloma, 13 males and 6 females, with the mean age of 45.1 (range 31 approximately 52). Pain was present in all patients. Nine patients had neurological deficit. According to Frankel classification 5 cases were Frankel B, 3 cases were Frenkel C, and 1 case was Frenkel D. Fourteen cases were diagnosed before operation, and 5 cases were diagnosed by pathology after operation. Surgical procedures performed included anterior approach in 11 cases, posterior approach in 7 cases and combined approach in 1 case.

Results: Decrease of pain was observed in all cases after surgery. Neurological improvement was observed in 8 out of the 9 cases. Complication (alteration of intestinal flora) occurred in one case. Follow-up lasted more than 1 year except in one case with a follow-up of only 6 months. Four cases were lost of follow-up. One case was still alive during the follow-up 8 years after operation. Other cases survived for 26.5 months on average (range 16 approximately 48 months).

Conclusion: Surgery can ensure neurological improvement and spinal stability for patients with spinal myeloma, but should be associated with adjunctive medical treatment.

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