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Review
. 2023 Oct-Dec;14(4):313-318.
doi: 10.4103/jcvjs.jcvjs_111_23. Epub 2023 Nov 29.

Lesions of the spinal cord caused by multiple myeloma: A systematic review and meta-analysis regarding the neurosurgical aspects of patient management

Daniel Encarnacion  1 , Gennady E Chmutin  1 , Ismail Bozkurt  2   3 , Jack Wellington  4 , Emmanuel Batista Geraldino  5 , Bipin Chaurasia  6
Affiliations
Review

Lesions of the spinal cord caused by multiple myeloma: A systematic review and meta-analysis regarding the neurosurgical aspects of patient management

Daniel Encarnacion et al. J Craniovertebr Junction Spine. 2023 Oct-Dec.

Abstract

Background: Multiple Myeloma is a B-cell malignancy which can cause variety of lesions of the spine and spinal cord. The management of patients with spinal cord compression (SCC), and the efficacy and security of minimally invasive therapeutic approaches, are the main topics of discussion.

Methods: To systematically review the scientific literature on neurosurgical aspects of MM spinal cord lesion management, a search was conducted among scientific papers in the databases ScienceDirect, Cochrane Library, and PubMed using keywords and Boolean operators. These comprise MM and lesions of the spine and spinal cord. Each database was searched from the earliest available article to January 2017.

Results: According to the literature, low-dose radiotherapy, antimyeloma medications, and bisphosphonates comprise the mainstay management for symptomatic spinal lesions. The decision to operation is based on presence of myelopathy and degree of spinal cord compression.

Conclusions: As a result of the analysis, the following conclusions may be drawn: (1) surgery is a valuable option for MM patients with symptomatic spinal involvement who experience rapid neurological deterioration with SCC and/or mechanical instability and (2) it is important to ensure that the benefits of surgical treatment outweigh the risks, as patients with MM are susceptible to infections.

Keywords: Lesions of the spine and spinal cord; meta-analysis; multiple myeloma; review.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol outlining the systematic review and meta-analysis flowchart of this article
Figure 2
Figure 2
Sagittal magnetic resonance imaging T1 according to the types of fractures. The stars show the postoperative fractures. (a) Osteoporotic fracture Type 1 fracture, osteoporotic type. Note the high intensity of the T1 signal, preserved according to the fractured vertebral body. There is no focal intervertebral lesion and there is no evidence at the pedicle level of epidural or paraspinal involvement. (b) Traumatic fracture Type 2 fracture, uncertain of underlying injuries. There was no focal, epidural, or paraspinal lesion in the treated vertebral body. (c) Myelomatous fracture Type 3 fracture, clear evidence of a myelomatous lesion within the vertebral body
Figure 3
Figure 3
OR lesions of the spinal cord caused by multiple myeloma studies
Figure 4
Figure 4
Bias risk summary
Figure 5
Figure 5
The total risk of bias
Figure 6
Figure 6
Kaplan–Meier survival curve showing magnetic resonance imaging patterns of the spine. Patients show various prognoses, (a) Progression-free survival and, (b) Overall survival
See this image and copyright information in PMC

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