Affiliations: Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Bonn, Germany
Correspondence:
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Corresponding author: Sönke P. Frey, Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Bonn, Sigmund-Freud-Str. 25 53105 Bonn, Germany. Tel.: +49 0151 11 345 820; Fax: + 49 0228 287 14175; E-mail:soenke.frey@ukb.uni-bonn.de
Abstract: BACKGROUND: Myeloma patients often suffer from painful vertebral fractures
(VCF) which impair their quality of life. Common methods for augmentation of
the vertebrae are vertebroplasty, kyphoplasty and radiofrequency-targeted
vertebral augmentation (RF-TVA).
OBJECTIVE: This study evaluates the long-term effectiveness and safety of
RF-TVA in the treatment of myeloma associated VCF.
METHODS: Eighty-seven myeloma patients (mean age: 64.7 ± 9.5 years)
with VCF were treated with RF-TVA. Patient data were assessed preoperatively
and in five postoperative examinations up to 12 months. Pain was measured
with the visual analogue scale (VAS) and the impairment was evaluated with
the Oswestry-Disability-Index (ODI) at each examination. In addition, the
mid vertebral height, kyphosis angle, and additional fractures were
evaluated by x-rays. Furthermore, cement leakage was documented.
RESULTS: The VAS values were significantly improved in comparison to the
preoperative values (p≤ 0.001), but slightly fluctuating during the
follow-up period. The ODI was also significantly improved (p≤ 0.001),
but it showed a worsening from the 12 months evaluation to the 24 months
evaluation. The kyphosis angle and the vertebral height were significantly
improved after surgery (p = 0.03, p ≤ 0.001), but worsened steadily to
the last follow up examination. Cement leakage was asymptomatic and occurred
in 18% of the patients. In 10% of the patients additional fractures
were detected in the 24 months evaluation.
CONCLUSIONS: The results of our study show that RF-TVA is a safe treatment
for myeloma associated vertebral compression fractures, which achieves an
acceptable improvement of patient's pain and quality of life.
