Risk of New Fractures in Vertebroplasty for Multiple Myeloma. A Retrospective Study
| Autor: | Andrés Rocha Romero, José Ramiro Espinoza-Zamora, Ricardo Plancarte-Sánchez, Ivan Hamiyd Salazar Carrera, Berenice Carolina Hernández-Porras, Reyna Guadalupe Ramos Nataren, Victor Alfonso De Los Reyes Pacheco, Gabriel Carvajal |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Percutaneous business.industry Retrospective cohort study General Medicine medicine.disease Logistic regression Confidence interval 030218 nuclear medicine & medical imaging Surgery 03 medical and health sciences 0302 clinical medicine Anesthesiology and Pain Medicine Lumbar Medicine Fracture level Neurology (clinical) business Cancer pain 030217 neurology & neurosurgery Multiple myeloma |
| Zdroj: | Pain Medicine. 21:3018-3023 |
| ISSN: | 1526-4637 1526-2375 |
| DOI: | 10.1093/pm/pnaa018 |
| Popis: | ObjectiveVertebroplasty is a percutaneous minimally invasive procedure indicated for vertebral collapse pain treatment. Among the known complications of the procedure is the augmented risk of new vertebral fractures. There are no specific studies in this patient population describing the risk of new vertebral fractures after vertebroplasty. This study analyzed risk factors associated with new vertebral fractures after vertebroplasty in patients with multiple myeloma.MethodsObservational retrospective study in patients with multiple myeloma. The data collection took place from January 1, 2010, to December 30, 2017, at the National Cancer Institute. Clinical data and procedural variables such as cement volume, cement leaks, fracture level, number of treated vertebrae, pedicular disease, and cement distribution pattern, with two years follow-up, were analyzed with the Wilcoxon test, and a logistic regression model was used to identify risk factors related to new vertebral fractures. A confidence interval of 95% was used for analysis.ResultsAt one-year follow-up, 30% of fractures were reported after vertebroplasty, most of them at low thoracic and lumbar level (50% adjacent level). Vertebroplasty was most commonly performed at the thoracolumbar and lumbar area. We demonstrated a 70.7% median numerical rating scale reduction at one-year follow-up; a significant decrease in opioid consumption occurred only during the first month.ConclusionsPedicle involvement, disc leakage, cement volume, thoracolumbar and lumbar level, and number of treated vertebrae by intervention are important risk factors when performing vertebroplasty. Prospective randomized studies are needed to evaluate these factors in this specific population. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|