There are approximately 20 000 new patients diagnosed with myeloma in the United States each year.1 With the availability of better treatments and resultant improved survival, there are currently close to 100 000 patients living with myeloma in the United States. Similar incidence and prevalence rates exist throughout Europe.2 Of these patients, the spine is affected by osteolytic and/or osteopenic bone disease in 70%.3 Myeloma is the commonest primary cancer affecting the spine. Painful vertebral compression fractures (VCFs) affect approximately 30% of myeloma patients. As myeloma patients live longer, it is especially relevant to provide the best available treatment for pain and reduce disabilities that can result from VCFs.4
The focus of this summary is to assess the role of minimally invasive percutaneous injection of polymethyl methacrylate (PMMA), first developed as ‘vertebroplasty’ in France in the late 1980s. Considerable experience accrued, especially in Europe, with the use of vertebroplasty as treatment for painful VCFs. The fractured bone fragments are stabilized and strengthened by PMMA and pain is substantially improved. A more recent modification of vertebroplasty is percutaneous balloon kyphoplasty whereby inflation of a balloon prior to PMMA injection can restore vertebral height and reduce kyphotic deformity in addition to stabilizing the fractured vertebral body.
Hussein MA, Vrionis FD, Allison R, Berenson J, Berven S, Erdem E, Giralt S, Jagannath S, Kyle RA, LeGrand S, Pflugmacher R, Raje N, Rajkumar SV, Randall RL, Roodman D, Siegel D, Vescio R, Zonder J, Durie BG; International Myeloma Working Group.
Leukemia. 2008 Aug;22(8):1479-84. doi: 10.1038/leu.2008.127. Epub 2008 May 29.