Analysis of the efficacy of separation surgery for severe neurological compression in multiple myeloma: a retrospective analysis of 35 cases
Purpose To investigate the effectiveness and safety of separation surgery for Epidural Spinal Cord Compression (ESCC) graded ≥ 2 in patients with Multiple Myeloma (MM), analyze factors influencing surgical outcomes, and develop a preliminary treatment decision framework for these patients. Methods A...
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| Veröffentlicht in: | European spine journal 2024-11, Vol.33 (11), p.4292-4301 |
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| creator | Liu, Jun-Peng Yao, Xing-Chen Wu, Yue Xu, Zi-Yu Li, Meng Shi, Ming Ren, Jie Du, Xin-Ru |
| description | Purpose
To investigate the effectiveness and safety of separation surgery for Epidural Spinal Cord Compression (ESCC) graded ≥ 2 in patients with Multiple Myeloma (MM), analyze factors influencing surgical outcomes, and develop a preliminary treatment decision framework for these patients.
Methods
A retrospective analysis was conducted on clinical data from 35 MM patients who underwent separation surgery for ESCC graded ≥ 2 between 2013 and 2018. Patient data, including baseline information, surgical details, complications, and pre-operative as well as one-month post-operative efficacy evaluation indicators were recorded. Statistical analysis was performed on pre-operative and post-operative efficacy indicators to determine if there were significant improvements (
p
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| doi_str_mv | 10.1007/s00586-024-08269-8 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_3045113218</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3123433962</sourcerecordid><originalsourceid>FETCH-LOGICAL-c326t-7c45f85997e17ef8538324dfeff596fceaa4bd21d3344df1cdea590bd29412443</originalsourceid><addsrcrecordid>eNp9kc1O3TAQha2qVbn8vEAXlaVu2KT1X5yYHUK0VELqpqwt44xpkBMHT4KUd-Ch8eXSFrFgZfv485kZH0I-cfaVM9Z8Q8bqVldMqIq1QpuqfUc2XElRMSPFe7JhRrFKN9zskX3EW8Z4bZj-SPZkq1WjmdqQh9PRxRV7pCnQ-Q9QCKH3zq_bM8Lkspv7NFJc8g3klYaUi3wPGegIS04x3RQ8Up-GKQPilu1HOixx7qcIdFghpsGdUEczzDnhBH7u74G6F3VlTb1DwEPyIbiIcPS8HpCr7-e_zy6qy18_fp6dXlZeCj1XjVd1aGtjGuANlJ1spVBdKK3XRgcPzqnrTvBOSlVk7jtwZfAiGcWFUvKAHO98p5zuFsDZDj16iNGNkBa0kqmacyl4W9Avr9DbtOTSe6G4kEpKo0WhxI7yZULMEOyU-8Hl1XJmt1nZXVa2ZGWfsrJb68_P1sv1AN2_J3_DKYDcAViuxvL9_2u_YfsI5G2how</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3123433962</pqid></control><display><type>article</type><title>Analysis of the efficacy of separation surgery for severe neurological compression in multiple myeloma: a retrospective analysis of 35 cases</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Liu, Jun-Peng ; Yao, Xing-Chen ; Wu, Yue ; Xu, Zi-Yu ; Li, Meng ; Shi, Ming ; Ren, Jie ; Du, Xin-Ru</creator><creatorcontrib>Liu, Jun-Peng ; Yao, Xing-Chen ; Wu, Yue ; Xu, Zi-Yu ; Li, Meng ; Shi, Ming ; Ren, Jie ; Du, Xin-Ru</creatorcontrib><description>Purpose
To investigate the effectiveness and safety of separation surgery for Epidural Spinal Cord Compression (ESCC) graded ≥ 2 in patients with Multiple Myeloma (MM), analyze factors influencing surgical outcomes, and develop a preliminary treatment decision framework for these patients.
Methods
A retrospective analysis was conducted on clinical data from 35 MM patients who underwent separation surgery for ESCC graded ≥ 2 between 2013 and 2018. Patient data, including baseline information, surgical details, complications, and pre-operative as well as one-month post-operative efficacy evaluation indicators were recorded. Statistical analysis was performed on pre-operative and post-operative efficacy indicators to determine if there were significant improvements (
p
< 0.05). Ordered logistic regression was utilized to assess factors associated with an unfavorable post-operative quality of life outcome.
Results
Compared to pre-operative values, at one-month post-surgery, patients showed significant improvements in Frankel Score Classification (4 vs 5,
p
< 0.05), Karnofsky Performance Score (30 vs 70,
p
< 0.05), and Visual Analogue Scale (8 vs 3,
p
< 0.05). Complications occurred in 7 cases (20%). The number of segments with ESCC (OR = 0.171,
p
< 0.05) and pre-operative chemotherapy (OR = 5.202,
p
= 0.05) were identified as independent factors influencing patient outcomes. Patients with more than two vertebral segments with ESCC exhibited significantly worse post-operative conditions.
Conclusions
Separation surgery effectively alleviates pain, improves neurological function, and enhances the quality of life in patients with ESCC graded ≥ 2 due to MM.</description><identifier>ISSN: 0940-6719</identifier><identifier>ISSN: 1432-0932</identifier><identifier>EISSN: 1432-0932</identifier><identifier>DOI: 10.1007/s00586-024-08269-8</identifier><identifier>PMID: 38647604</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adult ; Aged ; Chemotherapy ; Compression ; Decompression, Surgical - methods ; Female ; Humans ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Multiple myeloma ; Multiple Myeloma - complications ; Multiple Myeloma - surgery ; Neurosurgery ; Original Article ; Patients ; Quality of Life ; Retrospective Studies ; Spinal cord ; Spinal Cord Compression - etiology ; Spinal Cord Compression - surgery ; Statistical analysis ; Surgery ; Surgical Orthopedics ; Surgical outcomes ; Treatment Outcome ; Vertebrae</subject><ispartof>European spine journal, 2024-11, Vol.33 (11), p.4292-4301</ispartof><rights>The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2024. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c326t-7c45f85997e17ef8538324dfeff596fceaa4bd21d3344df1cdea590bd29412443</cites><orcidid>0000-0001-5092-9385</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00586-024-08269-8$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00586-024-08269-8$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38647604$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Liu, Jun-Peng</creatorcontrib><creatorcontrib>Yao, Xing-Chen</creatorcontrib><creatorcontrib>Wu, Yue</creatorcontrib><creatorcontrib>Xu, Zi-Yu</creatorcontrib><creatorcontrib>Li, Meng</creatorcontrib><creatorcontrib>Shi, Ming</creatorcontrib><creatorcontrib>Ren, Jie</creatorcontrib><creatorcontrib>Du, Xin-Ru</creatorcontrib><title>Analysis of the efficacy of separation surgery for severe neurological compression in multiple myeloma: a retrospective analysis of 35 cases</title><title>European spine journal</title><addtitle>Eur Spine J</addtitle><addtitle>Eur Spine J</addtitle><description>Purpose
To investigate the effectiveness and safety of separation surgery for Epidural Spinal Cord Compression (ESCC) graded ≥ 2 in patients with Multiple Myeloma (MM), analyze factors influencing surgical outcomes, and develop a preliminary treatment decision framework for these patients.
Methods
A retrospective analysis was conducted on clinical data from 35 MM patients who underwent separation surgery for ESCC graded ≥ 2 between 2013 and 2018. Patient data, including baseline information, surgical details, complications, and pre-operative as well as one-month post-operative efficacy evaluation indicators were recorded. Statistical analysis was performed on pre-operative and post-operative efficacy indicators to determine if there were significant improvements (
p
< 0.05). Ordered logistic regression was utilized to assess factors associated with an unfavorable post-operative quality of life outcome.
Results
Compared to pre-operative values, at one-month post-surgery, patients showed significant improvements in Frankel Score Classification (4 vs 5,
p
< 0.05), Karnofsky Performance Score (30 vs 70,
p
< 0.05), and Visual Analogue Scale (8 vs 3,
p
< 0.05). Complications occurred in 7 cases (20%). The number of segments with ESCC (OR = 0.171,
p
< 0.05) and pre-operative chemotherapy (OR = 5.202,
p
= 0.05) were identified as independent factors influencing patient outcomes. Patients with more than two vertebral segments with ESCC exhibited significantly worse post-operative conditions.
Conclusions
Separation surgery effectively alleviates pain, improves neurological function, and enhances the quality of life in patients with ESCC graded ≥ 2 due to MM.</description><subject>Adult</subject><subject>Aged</subject><subject>Chemotherapy</subject><subject>Compression</subject><subject>Decompression, Surgical - methods</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Multiple myeloma</subject><subject>Multiple Myeloma - complications</subject><subject>Multiple Myeloma - surgery</subject><subject>Neurosurgery</subject><subject>Original Article</subject><subject>Patients</subject><subject>Quality of Life</subject><subject>Retrospective Studies</subject><subject>Spinal cord</subject><subject>Spinal Cord Compression - etiology</subject><subject>Spinal Cord Compression - surgery</subject><subject>Statistical analysis</subject><subject>Surgery</subject><subject>Surgical Orthopedics</subject><subject>Surgical outcomes</subject><subject>Treatment Outcome</subject><subject>Vertebrae</subject><issn>0940-6719</issn><issn>1432-0932</issn><issn>1432-0932</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kc1O3TAQha2qVbn8vEAXlaVu2KT1X5yYHUK0VELqpqwt44xpkBMHT4KUd-Ch8eXSFrFgZfv485kZH0I-cfaVM9Z8Q8bqVldMqIq1QpuqfUc2XElRMSPFe7JhRrFKN9zskX3EW8Z4bZj-SPZkq1WjmdqQh9PRxRV7pCnQ-Q9QCKH3zq_bM8Lkspv7NFJc8g3klYaUi3wPGegIS04x3RQ8Up-GKQPilu1HOixx7qcIdFghpsGdUEczzDnhBH7u74G6F3VlTb1DwEPyIbiIcPS8HpCr7-e_zy6qy18_fp6dXlZeCj1XjVd1aGtjGuANlJ1spVBdKK3XRgcPzqnrTvBOSlVk7jtwZfAiGcWFUvKAHO98p5zuFsDZDj16iNGNkBa0kqmacyl4W9Avr9DbtOTSe6G4kEpKo0WhxI7yZULMEOyU-8Hl1XJmt1nZXVa2ZGWfsrJb68_P1sv1AN2_J3_DKYDcAViuxvL9_2u_YfsI5G2how</recordid><startdate>20241101</startdate><enddate>20241101</enddate><creator>Liu, Jun-Peng</creator><creator>Yao, Xing-Chen</creator><creator>Wu, Yue</creator><creator>Xu, Zi-Yu</creator><creator>Li, Meng</creator><creator>Shi, Ming</creator><creator>Ren, Jie</creator><creator>Du, Xin-Ru</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-5092-9385</orcidid></search><sort><creationdate>20241101</creationdate><title>Analysis of the efficacy of separation surgery for severe neurological compression in multiple myeloma: a retrospective analysis of 35 cases</title><author>Liu, Jun-Peng ; Yao, Xing-Chen ; Wu, Yue ; Xu, Zi-Yu ; Li, Meng ; Shi, Ming ; Ren, Jie ; Du, Xin-Ru</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c326t-7c45f85997e17ef8538324dfeff596fceaa4bd21d3344df1cdea590bd29412443</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Chemotherapy</topic><topic>Compression</topic><topic>Decompression, Surgical - methods</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Multiple myeloma</topic><topic>Multiple Myeloma - complications</topic><topic>Multiple Myeloma - surgery</topic><topic>Neurosurgery</topic><topic>Original Article</topic><topic>Patients</topic><topic>Quality of Life</topic><topic>Retrospective Studies</topic><topic>Spinal cord</topic><topic>Spinal Cord Compression - etiology</topic><topic>Spinal Cord Compression - surgery</topic><topic>Statistical analysis</topic><topic>Surgery</topic><topic>Surgical Orthopedics</topic><topic>Surgical outcomes</topic><topic>Treatment Outcome</topic><topic>Vertebrae</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Liu, Jun-Peng</creatorcontrib><creatorcontrib>Yao, Xing-Chen</creatorcontrib><creatorcontrib>Wu, Yue</creatorcontrib><creatorcontrib>Xu, Zi-Yu</creatorcontrib><creatorcontrib>Li, Meng</creatorcontrib><creatorcontrib>Shi, Ming</creatorcontrib><creatorcontrib>Ren, Jie</creatorcontrib><creatorcontrib>Du, Xin-Ru</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>European spine journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Liu, Jun-Peng</au><au>Yao, Xing-Chen</au><au>Wu, Yue</au><au>Xu, Zi-Yu</au><au>Li, Meng</au><au>Shi, Ming</au><au>Ren, Jie</au><au>Du, Xin-Ru</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Analysis of the efficacy of separation surgery for severe neurological compression in multiple myeloma: a retrospective analysis of 35 cases</atitle><jtitle>European spine journal</jtitle><stitle>Eur Spine J</stitle><addtitle>Eur Spine J</addtitle><date>2024-11-01</date><risdate>2024</risdate><volume>33</volume><issue>11</issue><spage>4292</spage><epage>4301</epage><pages>4292-4301</pages><issn>0940-6719</issn><issn>1432-0932</issn><eissn>1432-0932</eissn><abstract>Purpose
To investigate the effectiveness and safety of separation surgery for Epidural Spinal Cord Compression (ESCC) graded ≥ 2 in patients with Multiple Myeloma (MM), analyze factors influencing surgical outcomes, and develop a preliminary treatment decision framework for these patients.
Methods
A retrospective analysis was conducted on clinical data from 35 MM patients who underwent separation surgery for ESCC graded ≥ 2 between 2013 and 2018. Patient data, including baseline information, surgical details, complications, and pre-operative as well as one-month post-operative efficacy evaluation indicators were recorded. Statistical analysis was performed on pre-operative and post-operative efficacy indicators to determine if there were significant improvements (
p
< 0.05). Ordered logistic regression was utilized to assess factors associated with an unfavorable post-operative quality of life outcome.
Results
Compared to pre-operative values, at one-month post-surgery, patients showed significant improvements in Frankel Score Classification (4 vs 5,
p
< 0.05), Karnofsky Performance Score (30 vs 70,
p
< 0.05), and Visual Analogue Scale (8 vs 3,
p
< 0.05). Complications occurred in 7 cases (20%). The number of segments with ESCC (OR = 0.171,
p
< 0.05) and pre-operative chemotherapy (OR = 5.202,
p
= 0.05) were identified as independent factors influencing patient outcomes. Patients with more than two vertebral segments with ESCC exhibited significantly worse post-operative conditions.
Conclusions
Separation surgery effectively alleviates pain, improves neurological function, and enhances the quality of life in patients with ESCC graded ≥ 2 due to MM.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>38647604</pmid><doi>10.1007/s00586-024-08269-8</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0001-5092-9385</orcidid></addata></record> |
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| ispartof | European spine journal, 2024-11, Vol.33 (11), p.4292-4301 |
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| subjects | Adult Aged Chemotherapy Compression Decompression, Surgical - methods Female Humans Male Medicine Medicine & Public Health Middle Aged Multiple myeloma Multiple Myeloma - complications Multiple Myeloma - surgery Neurosurgery Original Article Patients Quality of Life Retrospective Studies Spinal cord Spinal Cord Compression - etiology Spinal Cord Compression - surgery Statistical analysis Surgery Surgical Orthopedics Surgical outcomes Treatment Outcome Vertebrae |
| title | Analysis of the efficacy of separation surgery for severe neurological compression in multiple myeloma: a retrospective analysis of 35 cases |
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