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Surgical Management of Bone Disease

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Myeloma Bone Disease

Part of the book series: Current Clinical Oncology ((CCO))

Abstract

Minimally invasive surgery plays an increasingly important role in the management of bone disease in patients with myeloma. The spine is the most common site of bone involvement in myeloma, and minimally invasive vertebral augmentation techniques have been developed which are safe and effective in relieving pain related to vertebral compression fractures in patients with myeloma. Vertebroplasty relieves pain and stabilizes the fractured vertebral body by injecting bone cement percutaneously into the cancellous area, however more recently its role in pain management has been questioned in two double blinded randomized clinical trials. Kyphoplasty is a similar technique, but uses an inflatable tamp to create a uniform cavity in which the bone cement is injected. Compared with vertebroplasty, kyphoplasty is associated with less cement leakage and has the added advantage of restoring vertebral height, which relieves stress on adjacent vertebral bodies and may reduce the risk of additional fractures. Continued improvements in myeloma therapy and the development of these minimally invasive techniques have increased the potential for more patients to be eligible for vertebral augmentation, which may have a favorable impact on pain, disability, quality of life, and even reduction in mortality. Vertebral augmentation is the procedure of choice for myeloma patients with severe pain related to vertebral compression fractures and may play a role in relieving pain and preventing impending fractures in patients with other conditions.

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Authors and Affiliations

  1. Celgene Corporation, Summit, NJ, 07901, USA

    Mohamad A. Hussein

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  1. Mohamad A. Hussein
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Correspondence to Mohamad A. Hussein .

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  1. Dept. Medicine, University of Pittsburgh, Centre Avenue 5115, Pittsburgh, 15232, USA

    G. David Roodman

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Hussein, M.A. (2010). Surgical Management of Bone Disease. In: Roodman, G. (eds) Myeloma Bone Disease. Current Clinical Oncology. Humana Press. https://doi.org/10.1007/978-1-60761-554-5_5

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  • DOI: https://doi.org/10.1007/978-1-60761-554-5_5

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