One-stage Multilevel Vertebroplasty - 4 or More Levels in Patients with Multiple Myeloma – Series Overview

Introduction: Patients with multiple myeloma (MM) are at high risk for vertebral compression fractures, and the application of vertebroplasty (PV) is expanding into this patient population.

Methods: We performed a retrospective review of clinical outcome data from 21 multiple myeloma patients (8 males and 13 females) treated with one-stage multilevel vertebroplasty (4 or more levels) since January 2020 to August 2024. In all patients preoperative CT scans were performed. Patients were followed up with VAS scale for pain and qualitative outcome data (self-reported pain, mobility, and narcotic use) preoperatively, immediately after vertebroplasty, and at 1 week and 1 month after the treatment.

Results: Vertebroplasty was performed on 104 vertebral levels in the 21 patients in our study group. The most operated vertebrae were in thoracolumbar region (58%) and average operative time was about 45 minutes. In 9 patients cement leakage occurred with no clinical significance. The average preoperative VAS score was 7.1pt., immediately postoperatively it was 2.4pt, within 1 week was 1.6pt. and after 1 month 2.2pt. In period of one month 73% of patients experienced a significant improvement in subjective rest pain and activity pain. Subjective scores achieved durable improvements, with 50% of patients requiring fewer narcotics after vertebroplasty and 65% having improved mobility.

Conclusion : One-stage multilevel PV provides pain relief for patients with multiple compression fractures due to multiple myeloma. However, these patients need follow-up and additional treatment.