Dados do Trabalho

Título

Spinal disease in Multiple Myeloma: Who gets spinal cord compression syndrome ? . A cases series study

Objetivo

To describe the clinical and laboratory characteristics of patients with spine disease due to multiple myeloma infiltration and analyze the rate of spinal cord compression syndrome among them, making special attention to immunoglobulin type and spine level affected between patients with spine disease with spinal cord compression and patients with spine disease without spinal cord compression syndrome.

Metodologia

After institutional board approval, patients with a diagnosis of Multiple Myeloma and spine disease from 2014 to December 2019 were selected, of them a total of 140 patients were analyzed.
The patients were distributed into 2 groups, group A was patients with spine disease due to Multiple Myeloma and spinal cord compression syndrome and Group B was patients with spine disease due to Multiple Myeloma without spinal cord compression syndrome. Spinal cord compression syndrome was defined as either paraparesis with Frankel scale or cauda equina syndrome. Clinical and laboratory history was analyzed, including the type of immunoglobulin at the diagnosis of Multiple Myeloma, and the spinal level affected.

Resultados

From 140 patients analyzed, 45 patients were in group A and 95 in group B, spinal cord compression syndrome was most frequent on the female than male patients (26 VS 19 patients ), IgG was the most frequent inmunoglobulin in Spinal cord compression syndrome patients (32 patients,71,1%), following by IgA (11 patients, 24,44%), IgD and IgM both with 1 patient (2,22% for each of them ).
Frankel A was present in 22 patients (48.8%) of group A patients, Frankel B in 3 patients (6,66%) , Frankel C in 13 patients (28,8%) , Frankel D in 3 patients (6,66%) and Frankel E in 4 patients (8,88%). The most frequent spinal level affected with multiple myeloma with spinal cord compression syndrome was the thoracic spine (51,1%).
In group B, the most frequent spinal level affected by multiple myeloma was the thoracic spine (57,89% ), followed by the cervical spine (42,1%), and the male patients were most prevalent than female (81,05% VS 18,95%).finally, IgG was the most frequent immunoglobulin among patients with the spinal disease without spinal cord compression syndrome (70,52%)

Conclusões

Spinal cord compression syndrome is a devasting complication of Multiple Myeloma, which is the most frequent spine metastasis among adults, here we describe a series of 140 patients with spine disease affected by multiple myeloma in whom spinal cord compression syndrome was present in 32,14% of them, in which the IgG and female sex was prevalent.