ABSTRACT
BACKGROUND AND PURPOSE: Spinal lesions with marked destruction are common site of morbidity in patients with multiple myeloma causing serious clinical symptoms. The aim of the study was to evaluate the therapeutic benefit of percutaneous vertebroplasty (PVP) in treating vertebral body lesions in patients suffering from multiple myeloma. MATERIALS AND METHODS: Twenty nine patients (55 vertebral bodies) were treated after complete diagnostic evaluation, preparation and obtaining informed consent. Needle position and acrylic material injection was performed under fluoroscopic guidance. RESULTS: Average visual analogue score dropped from 7.8 before to 2.3 after the intervention. Soft tissue leak was present at 9 treated levels, small epidural cement collection at 5, venous leak at 4 and intradiscal leak at 3 levels without any clinically manifest complications. The effects of PVP were stable in all of the patients at 12 months follow-up. Subjective outcome scores collected through follow-up showed improvement of +1.45 in pain, + 1.15 in ambulation and + 1.23 in medication use. There were recurrence of back pain in 9 patients at non-treated levels due to the new lesions. CONCLUSION: In our series, PVP of painful lesions caused by multiple myeloma provides immediate and long-term pain relief. The procedure is safe and, despite of the present leakage of cement, may be performed on outpatients basis.
Subject(s)
Back Pain/therapy , Bone Cements/therapeutic use , Multiple Myeloma/complications , Polymethyl Methacrylate/therapeutic use , Spinal Diseases/therapy , Vertebroplasty , Aged , Back Pain/etiology , Female , Humans , Male , Middle Aged , Pain Measurement , Radiography, Interventional , Spinal Diseases/diagnostic imaging , Spinal Diseases/etiologyABSTRACT
The fracture of tibia shaft is one of the most common fracture of long bones. The authors bring out the results of the treatment of 90 patients with unstable closed tibial shaft fractures treated by the use of Mitkovic external fixation systems. Within the analayzed group there were 66 (73%) male and 24 (27%) female. The average patients age was 43.9 years (range 15 to 82). Excellent result in treatment of unstable closed tibial shaft fractures with external fixation were achieved in 15 (16,7%) patients, very good in 38 (42,2%) patients, good in 24 (26,7%), poor in 9 (10%) and bad in 4 (4,4%) patients. With 4 (4,4%) patients pseudoarthrosis was formed. Additional treatment of patients with pseudoarthrosis (spongioplastic and placing of CD device) led to pseudoarthrosis healing. Within the analyzed group in all patients treated with extenal fixation there were no registered cases of postoperative osteitis. External fixation by the use of Mitkovic external fixation is one of the method of choose in the treatment of unstable closed tibial fractures, providing dynamic and balanced biomehanical conditions for fracture healing.
