Percutaneus osteoplasty in the treatment of extraspinal painful multiple myeloma lesions.

Purpose: The aim of our study was to assess the efficacy and safety of percutaneous osteoplasty (PO), a technical extension of percutaneous vertebroplasty, in the treatment of extraspinal bone lesions from multiple myeloma causing pain resistant to NSAID therapy or treated with opioids.

Methods: Between March 2006 and January 2009, 39 patients (22 female), median age 64 years (range 48-88 years) with diagnosis of multiple myeloma, were treated with percutaneous osteoplasty for painful extraspinal bone lesions resistant to NSAID therapy or treated with opioids.

Results: Technical success was achieved in all cases. Mean visual analog pain score (VAS) scores dropped from 8.4 ± 1 (range 6-10; pretreatment) to 2.1 ± 1.7 (range 0-7; 24-h posttreatment). Pain completely disappeared in six (15%) patients. Administration of analgesics was suspended in 16 (41%) patients whereas in 17 (43.5%) patients previously treated with opioids, residual pain was controlled by NSAIDs. In six (15%) patients, narcotics administration was continued due to the persistence of pain. All patients completed an at least 6-month follow-up with a median long-term VAS score of 2.4 ± 2.1 (range 0-9). In five (13%) patients, pain remission was complete, with no recurrence at 18 months from treatment.

Conclusion: Our study suggests that PO may be feasible, effective, and safe in the treatment of conventional therapy-resistant extraspinal painful multiple myeloma lesions providing long-lasting pain relief with occasional tumor control and a significant reduction in the assumption of analgesic drugs.