Multiple myeloma surgery: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Multiple myeloma}} | {{Multiple myeloma}} | ||
{{CMG}} {{AE}}{{HL}} | {{CMG}} {{AE}}{{HL}} {{shyam} | ||
==Overview== | ==Overview== | ||
Surgery is not the first-line treatment option for patients with multiple myeloma. Emergency surgery is usually reserved for patients with either spine or leg fractures. | Surgery is not the first-line treatment option for patients with multiple myeloma. Emergency surgery is usually reserved for patients with either spine or leg fractures.<ref>Treatment of multiple myeloma. Canadian Cancer Society (2015) http://www.cancer.ca/en/cancer-information/cancer-type/multiple-myeloma/treatment/?region=mb Accessed on September, 20th 2015</ref> | ||
<ref> | ===Surgical Removal of Plasmacytoma=== | ||
===Surgery for Osseous Involvement=== | |||
In many patients with multiple myeloma, bone involvement can lead to significant pain and limitation of mobility. Lytic lesions in the axial or appendicular skeleton may require surgical intervention for stabilization. The most common anatomic site that requires surgical stabilization is the vertebral spine, as pathologic fractures can result in spinal cord compromise and subsequent neurological deficits.<ref name="pmid29530691">{{cite journal| author=Quidet M, Zairi F, Boyle E, Facon T, Vieillard MH, Machuron F et al.| title=Evaluation of the Relevance of Surgery in Patients with Multiple Myeloma Harboring Symptomatic Spinal Involvement: A Retrospective Case Series. | journal=World Neurosurg | year= 2018 | volume= 114 | issue= | pages= e356-e365 | pmid=29530691 | doi=10.1016/j.wneu.2018.02.184 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29530691 }} </ref> Decompression, fixation, or other surgical techniques may be required to prevent impending spinal cord damage.<ref name="pmid29530691">{{cite journal| author=Quidet M, Zairi F, Boyle E, Facon T, Vieillard MH, Machuron F et al.| title=Evaluation of the Relevance of Surgery in Patients with Multiple Myeloma Harboring Symptomatic Spinal Involvement: A Retrospective Case Series. | journal=World Neurosurg | year= 2018 | volume= 114 | issue= | pages= e356-e365 | pmid=29530691 | doi=10.1016/j.wneu.2018.02.184 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29530691 }} </ref> The beenfits of surgery for patients with multiple myeloma with lytic lesions include: | |||
*Pain relief: Surgical stabilization of lytic lesions can improve pain symptoms | |||
*Restoration of functional disability: Stabilization of lytic lesions provides mechanical and structural support for the axial and appendicular skeleton. | |||
*Alleviation of neurologic deficits: Stabilization of the spine can help alleviate neurologic defects that were caused by compressive neurologic damage. The most common neurological symptoms include lower extremity numbness, lower extremity weakness, decreased deep tendon reflexes, and impaired gait. These neurologic functions are supplied by the nerve roots located near the thoracic and lumbar spine, which are the most common sites of lytic lesions in patients with multiple myeloma.<ref name="pmid29530691">{{cite journal| author=Quidet M, Zairi F, Boyle E, Facon T, Vieillard MH, Machuron F et al.| title=Evaluation of the Relevance of Surgery in Patients with Multiple Myeloma Harboring Symptomatic Spinal Involvement: A Retrospective Case Series. | journal=World Neurosurg | year= 2018 | volume= 114 | issue= | pages= e356-e365 | pmid=29530691 | doi=10.1016/j.wneu.2018.02.184 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29530691 }} </ref> | |||
==References== | ==References== | ||
Revision as of 23:32, 21 July 2018
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Haytham Allaham, M.D. [2] {{shyam}
Overview
Surgery is not the first-line treatment option for patients with multiple myeloma. Emergency surgery is usually reserved for patients with either spine or leg fractures.[1]
Surgical Removal of Plasmacytoma
Surgery for Osseous Involvement
In many patients with multiple myeloma, bone involvement can lead to significant pain and limitation of mobility. Lytic lesions in the axial or appendicular skeleton may require surgical intervention for stabilization. The most common anatomic site that requires surgical stabilization is the vertebral spine, as pathologic fractures can result in spinal cord compromise and subsequent neurological deficits.[2] Decompression, fixation, or other surgical techniques may be required to prevent impending spinal cord damage.[2] The beenfits of surgery for patients with multiple myeloma with lytic lesions include:
- Pain relief: Surgical stabilization of lytic lesions can improve pain symptoms
- Restoration of functional disability: Stabilization of lytic lesions provides mechanical and structural support for the axial and appendicular skeleton.
- Alleviation of neurologic deficits: Stabilization of the spine can help alleviate neurologic defects that were caused by compressive neurologic damage. The most common neurological symptoms include lower extremity numbness, lower extremity weakness, decreased deep tendon reflexes, and impaired gait. These neurologic functions are supplied by the nerve roots located near the thoracic and lumbar spine, which are the most common sites of lytic lesions in patients with multiple myeloma.[2]
References
- ↑ Treatment of multiple myeloma. Canadian Cancer Society (2015) http://www.cancer.ca/en/cancer-information/cancer-type/multiple-myeloma/treatment/?region=mb Accessed on September, 20th 2015
- ↑ 2.0 2.1 2.2 Quidet M, Zairi F, Boyle E, Facon T, Vieillard MH, Machuron F; et al. (2018). "Evaluation of the Relevance of Surgery in Patients with Multiple Myeloma Harboring Symptomatic Spinal Involvement: A Retrospective Case Series". World Neurosurg. 114: e356–e365. doi:10.1016/j.wneu.2018.02.184. PMID 29530691.