DOI: 10.36347/sjams.2019.v07i11.072

Pages: 3839-3843

Background: Multiple myeloma frequently causes painful vertebral compression fractures that persist despite analgesics, systemic therapy, radiotherapy, and bisphosphonates. Percutaneous vertebroplasty offers rapid mechanical stabilization and analgesia, but data from low and middle income settings remain limited. Objective: To evaluate pain outcomes and selected clinical parameters following vertebroplasty for multiple myeloma in different private hospitals and Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. Methods: We retrospectively reviewed all consecutive multiple myeloma patients undergoing fluoroscopy guided transpedicular polymethyl methacrylate (PMMA) vertebroplasty between July 2010 and June 2019. Demographic data, number of vertebral levels treated, pre procedure pain (three point scale: mild/moderate/severe)? Prior systemic chemotherapy, bisphosphonate exposure, radiotherapy timing, and need for spine surgery were abstracted. Post procedure pain response was categorized as improved vs not improved. Where direct follow up was available, change in pain score was analyzed (Wilcoxon Signed Rank; p≤0.05). Results: Twenty patients were included (62% male). Age distribution: 15% aged 40–49 years, 35% 50–59, 23% 60–69, and 27% ≥70. Multilevel disease was common: 50% had three vertebral sites treated, 19% two sites, and 31% one site. Pre procedure pain was severe in 65% and moderate in 35%. Most patients had received systemic chemotherapy (89%) and bisphosphonates (81%). Radiotherapy had been given pre procedure in 39%, post procedure in 15%, both in 4%, and not at all in 42%. Following vertebroplasty, 77% reported meaningful pain relief; 23% reported no improvement. Only 15% underwent spinal surgery at any point during care. Conclusion: In this multicentric study in Bangladesh, vertebroplasty provided clinically meaningful pain relief for most patients with myeloma related vertebral disease and was associated with a low subsequent need for spina