Surgical Treatment of Spinal Plasma Cell Tumors.

Shin, Myoung Ju; Oh, Sung Han; Yoon, Do Heum; Chin, Dong Kyu; Cho, Yong Eun; Kim, Young Soo

Original Article

Journal of Korean Neurosurgical Society 2002;32(2): 118-124.

Myoung Ju Shin, Sung Han Oh, Do Heum Yoon, Dong Kyu Chin, Yong Eun Cho, Young Soo Kim

Department of Neurosurgery, Yonsei University, College of Medicine, Seoul, Korea.

ABSTRACT

OBJECTIVE
The purpose of this study is to review the cases of spinal plasma cell tumors treated in our department with regard to presenting symptoms and signs, diagnostic investigations, extent of surgical interventions, complications, survival time and influence on the quality of life.
METHODS
In a retrospective study, twelve spinal plasma cell tumor patients who underwent surgery were evaluated between Oct. 1991 and Dec. 2000. Clinical staging system was evaluated by Durie-Salmon Staging System.
RESULTS
There were multiple myeloma in nine and solitary plasmacytoma in three patients, six men and six women and aged 38 to 69 years(mean 56.8 years). The locations of the lesions were two cervical, two cervico-thoracic, three thoracic, one thoraco-lumbar, three lumbar and one sacral. The most common initial presenting symptom and sign were local pain and motor weakness. Radiographs showed pathologic compression fracture in six and the MRI finding were cortical infolding, focal to diffuse patterns of low-signal on T1WI, high signal intensity on T2WI, and variable of enhancement on Gadolinium enhanced T1W1. Sixteen operations were performed. and the adjuvant theraphy included radiotheraphy, chemotheraphy(combined oral melphalan and predinisone), and autologous PBST(peripheral blood stem cell transplantation). The follow-up period was three to sixty months(mean 27.0 months). The mean Karnofsky scale score was changed from 54.5 to 73.3 after follow up. One patient died of pulmonary metastasis and sepsis.
CONCLUSION
Our experience suggests that treatment of spinal plasma cell tumor may be rewarding.

Key Words: Spinal plasma cell tumor; Surgical intervention; PMMA(polymethylmethacrylate)