Jurczyszyn Artur, Czepko Ryszard, Banach Mariusz, Godlewski Bartosz, Czepko Ryszard Adam, Masłowski Przemysław, Skotnicki Aleksander B
Department of Hematology, Jagiellonian University Medical College, Kraków, Poland.
Department of Neurosurgery, St. Raphael's Hospital, Kraków, Poland.
Adv Clin Exp Med. 2015 Jul-Aug;24(4):651-6. doi: 10.17219/acem/38556.
In patients with multiple myeloma (MM) there is a high risk of compression fractures of the spine. In the majority of cases, the method of treatment is percutaneous vertebroplasty (PV) or kyphoplasty (PK). The number of studies verifying their efficacy in MM is still relatively small.
The aim of this study has been to assess medium- and long-term pain relief as well as improvement in the quality of life (QL) after PV in MM cases.
There was a prospective group of 34 MM cases in which a total of 131 vertebral bodies were augmented by means of PV. It was possible to follow up 22 patients who agreed to take part in the assessment. Their level of daily activity and the level of pain were assessed using the Oswestry Back Pain scale and a visual analogue scale (VAS) before PV and at a later date (medium-term follow up was a mean of 10 months after the last operation). Five out of eight cases in which 4.5-5 years had elapsed since the first PV were tested again (long-term follow-up).
Relief of pain and improvement of QL, assessed a mean of 10 months after PV, proved to be statistically significant. On the average, pain decreased by 4.7 points as measured on the VAS scale and the average improvement in the QL measured on the Oswestry scale was 27.7%. There were no neurological or general complications. After 4.5-5 years, there has not been any significant change in the level of pain relief or the improvement in the QL in the 5 cases in which long-term assessment was possible.
In MM cases, PV is a simple, effective and safe method for the treatment of vertebral infiltration and compression fractures, giving permanent long-term pain relief and concomitant improvement in the QL.
在多发性骨髓瘤（MM）患者中，脊柱压缩性骨折风险较高。在大多数情况下，治疗方法是经皮椎体成形术（PV）或后凸成形术（PK）。验证其在MM中疗效的研究数量仍然相对较少。
本研究的目的是评估MM患者接受PV治疗后的中长期疼痛缓解情况以及生活质量（QL）的改善情况。
前瞻性纳入34例MM患者，共131个椎体接受了PV治疗。对22例同意参与评估的患者进行了随访。在PV治疗前及之后（中期随访为最后一次手术后平均10个月），使用Oswestry背痛量表和视觉模拟量表（VAS）评估他们的日常活动水平和疼痛程度。对首次PV治疗后已过去4.5 - 5年的8例患者中的5例进行了再次测试（长期随访）。
PV治疗后平均10个月评估的疼痛缓解和QL改善具有统计学意义。平均而言，VAS量表上疼痛降低了4.7分，Oswestry量表上QL的平均改善为27.7%。未出现神经或全身并发症。在可进行长期评估的5例患者中，4.5 - 5年后疼痛缓解程度或QL改善情况未出现任何显著变化。
在MM患者中，PV是治疗椎体浸润和压缩性骨折的一种简单、有效且安全的方法，可实现长期持续的疼痛缓解并同时改善QL。
