Background: In nearly 30% of patients with myeloma, pathological fractures are found to occur in the spine.\nIf the patients are not treated promptly and satisfactorily, the quality of their lives diminishes. Currently, the\nstandard treatment for metastatic lesions of the spine is radiotherapy, but surgical intervention is becoming\nmore frequent. It is very important to quickly identify metastases and implement surgical treatment before\nany fracture/s occur.\nMethods: Over the period of 2010ââ?¬â??2014 in our department, a total of 129 patients were treated for metastatic spinal\nmyeloma. 73 patients underwent vertebroplasty and 56 patients were operated on through various methods. Indications\nfor the surgery, its course, technique and outcome were subsequently evaluated. The majority of patients (76%) admitted\nfor treatment, exhibited vertebral fractures. Most lesions were multiplace and involved the vertebral bodies. In 42% of the\npatients, radiological examinations showed symptoms of compression of the nervous structures, while clinical signs were\nobserved in only 16% of the patients. The functional status of the patients was assessed using the Karnofsky scale, while\npain intensity was measured in a VAS score, before and after the surgery. The oncological results were assessed as a\nsurvival rate and local recurrence rate.\nResults: The average follow-up was conducted within 31 months (min 18, max 48). The patients after vertebroplasty\nsurvived 42 months, and the patients after surgery 23 months. Local recurrence of the disease was observed in 12\npatients. In 10 patients, among a group of 21 with paresis, their neurological conditions improved. The average results of\nboth their VAS score and Karnofsky performance score in patients after surgery was seen to have improved. Only sporadic\npostoperative complications after vertebroplasty and surgery were reported.\nConclusions: Early diagnosis of myeloma spine metastasis is essential to achieve the desired results of\ntreatment. Vertebroplasty, as advised, should be performed as early as possible. Both the functional and\noncological results after vertebroplasty are beneficial and the complication rates are low. Three relevant\nfactors were found in our study: patientââ?¬â?¢s age over 65 years, initial diagnosis over 3 years and stage III of\ndisease were related, significantly and statistically to survival.
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