Renier J C, Brégeon C, Boasson M, Audran M, Emile J, Guy G, Mercier P, Pidhorz L, Cornu P, Durier C
Rev Rhum Mal Osteoartic. 1984 Apr;51(4):193-6.
Ten cases of multiple myeloma with spinal cord compression are reported. The compression was located in the thoracic spine in 9 cases and in the cervical spine in 1 case. It led to the discovery of the myeloma in 4 cases. Three patients suffered, during several months, from local pain aggravated by activity and from slight and slowly progressive neurologic symptoms resembling intermittent claudication. At the time of diagnosis, sphincter dysfunction was observed only in patients with low thoracic cord compressions. In 4 cases, lesions were first treated by radiotherapy which did not produce regression of the compression. Tumor excision surgery was carried out seven times, once after failure of radiotherapy. In 6 cases an definite and steady regression of the neurological symptoms was achieved. Survival varied from 10 months to 7.5 years after identification of spinal cord compression. Survival was equal to or more than 3 years in 4 patients and will probably reach 3 years in another. Thus spinal cord compression is not by itself a sign indicating a poor short term prognosis in multiple myeloma. It should be treated by excision surgery, then by chemotherapy as in multiple myeloma at other sites.
报告了10例伴有脊髓压迫的多发性骨髓瘤病例。压迫位于胸椎的有9例，位于颈椎的有1例。4例因脊髓压迫而发现骨髓瘤。3例患者在数月内出现活动后加重的局部疼痛以及类似间歇性跛行的轻微且逐渐进展的神经症状。诊断时，仅在胸段脊髓低位受压的患者中观察到括约肌功能障碍。4例患者首先接受放疗，但压迫未消退。7次进行了肿瘤切除手术，其中1次是在放疗失败后进行的。6例患者的神经症状实现了明确且稳定的消退。脊髓压迫确诊后的生存时间从10个月到7.5年不等。4例患者的生存时间等于或超过3年，另一例可能也会达到3年。因此，脊髓压迫本身并非多发性骨髓瘤短期预后不良的标志。应先通过切除手术治疗，然后像治疗其他部位的多发性骨髓瘤一样进行化疗。
