Almetrek Metrek A, Mahjari Ahood A, Aldharman Sarah S, Amer Khaled A, Balobaid Manar F, Madkhali Abdullah, Alsayary Aisha M, Alsubaie Sarah F
Family Medicine, Ministry of Health Holdings, Abha, SAU.
College of Medicine, Najran University, Najran, SAU.
Cureus. 2023 Jan 8;15(1):e33505. doi: 10.7759/cureus.33505. eCollection 2023 Jan.
Vertebral disease is a main source of morbidity (MM) in individuals with multiple myeloma. The effects of associated osteolytic lesions and vertebral fractures on severe pain, functional limits, spinal deformity, and cord compression are well recognized. Systemic therapy, radiation, cementoplasty (vertebroplasty/kyphoplasty), and radiofrequency ablation are now available therapeutic options for severe MM spinal pain. We here reported a case of a 45-year-old male who had complained of progressive symptoms of pathological spine fractures. He had been examined and investigated for the cause of lytic lesions and found to have multiple fractures in the spine. A computed tomography (CT) revealed multiple osteolytic lesions noted in the thoracolumbar spine, ribs (bilaterally), and pelvic bones. Magnetic resonance imaging (MRI) showed a compression fracture of the T8 vertebral body with evidence of retro-bulging and a spinal canal narrowing. However, there was no evidence of spinal cord abnormal signal intensity. T2 weighted image (T2WI) keeping with edema is noted. A surgical intervention fixed the fracture and improved the quality of life. Vertebroplasty, a minimally invasive procedure, as a treatment option for vertebral lesions and pathologic fractures in the MM, showed good clinical improvement in the patient.
脊柱疾病是多发性骨髓瘤患者发病的主要原因。相关溶骨性病变和椎体骨折对剧痛、功能受限、脊柱畸形和脊髓压迫的影响已得到充分认识。全身治疗、放疗、骨水泥成形术（椎体成形术/后凸成形术）和射频消融是目前治疗严重骨髓瘤脊柱疼痛的可用治疗选择。我们在此报告一例45岁男性病例，该患者主诉病理性脊柱骨折症状进行性加重。他接受了检查并对溶骨性病变的病因进行了调查，发现脊柱有多处骨折。计算机断层扫描（CT）显示胸腰椎、肋骨（双侧）和骨盆骨有多处溶骨性病变。磁共振成像（MRI）显示T8椎体压缩性骨折，伴有后凸和椎管狭窄。然而，没有脊髓异常信号强度的证据。可见符合水肿的T2加权像（T2WI）。手术干预固定了骨折并改善了生活质量。椎体成形术作为一种微创手术，作为骨髓瘤椎体病变和病理性骨折的治疗选择，在该患者中显示出良好的临床改善效果。
