Treatment approaches for multiple Myeloma vertebral column lesions – Results from an international survey distributed to the AO spine knowledge forum tumor
Introduction: Vertebral fractures and epidural compression are common complications in Multiple Myeloma (MM). Although non-surgical management is generally preferred, internationally accepted management guidelines are lacking. This study aimed to assess current international treatment approaches and...
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Elsevier
2025-01-01
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| Series: | Brain and Spine |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2772529425002061 |
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| author | Vanessa Hubertus Emily J. von Bronewski Lucius S. Fekonja Anton M. Früh Christian J. Entenmann Hannah Miller Charlotte Buhre Michael G. Fehlings Ilya Laufer Peter Vajkoczy Julia S. Onken |
| author_facet | Vanessa Hubertus Emily J. von Bronewski Lucius S. Fekonja Anton M. Früh Christian J. Entenmann Hannah Miller Charlotte Buhre Michael G. Fehlings Ilya Laufer Peter Vajkoczy Julia S. Onken |
| author_sort | Vanessa Hubertus |
| collection | DOAJ |
| description | Introduction: Vertebral fractures and epidural compression are common complications in Multiple Myeloma (MM). Although non-surgical management is generally preferred, internationally accepted management guidelines are lacking. This study aimed to assess current international treatment approaches and clinical conditions guiding decision-making in MM vertebral lesions. Research question: Assessing international treatment standards for MM vertebral column lesions. Material and methods: A survey was distributed to members of the AO Spine Knowledge Forum Tumor, an expert forum specialized on the treatment of oncologic spine disease. The survey consisted of 25 questions, of which 15 assessed the participant's background, clinical expertise, and experienced treatment standards regarding MM vertebral lesions, followed by ten fictional case examples with seven possible treatment scenarios each. Results: 51 international experts completed the survey, 51 % being of orthopedic, and 44 % of neurosurgical background, while 5 % were radio-oncologists. 84 % of the participants stated they “see vertebral lesions in MM in general as a non-surgical disease”. As strongest indicators to perform surgery, neurological deficits (74 %), and potentially unstable lesions (20 %) were chosen. Clinical and radiological follow-up is performed by 83 %, however only in 46 % at defined intervals. 89 % would choose “less invasive” surgical strategies in MM than in similar lesions related to metastatic spine disease. Discussion and conclusion: The participating experts agreed towards a more restrained and less invasive management of MM patients, however the applicability of surgical scores, standards for follow-up, and indications as well as surgical strategies for MM vertebral lesions varied widely, illustrating the need for international guidelines standardizing treatment. |
| format | Article |
| id | doaj-art-8cadd5b901724393b6b33bc5c6fac42e |
| institution | Kabale University |
| issn | 2772-5294 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Brain and Spine |
| spelling | doaj-art-8cadd5b901724393b6b33bc5c6fac42e2025-08-20T03:36:18ZengElsevierBrain and Spine2772-52942025-01-01510438710.1016/j.bas.2025.104387Treatment approaches for multiple Myeloma vertebral column lesions – Results from an international survey distributed to the AO spine knowledge forum tumorVanessa Hubertus0Emily J. von Bronewski1Lucius S. Fekonja2Anton M. Früh3Christian J. Entenmann4Hannah Miller5Charlotte Buhre6Michael G. Fehlings7Ilya Laufer8Peter Vajkoczy9Julia S. Onken10Department of Neurosurgery, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, And Berlin Institute of Health, Germany; BIH – Berlin Institute of Health Charité Clinician Scientist Program, Berlin Institute of Health, Berlin, Germany; Corresponding author. Charité – Universitätsmedizin Berlin , Department of Neurosurgery , Berlin Institute of Health Clinician Scientist Program, Charitéplatz 1, 10117, Berlin, Germany.Department of Neurosurgery, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, And Berlin Institute of Health, GermanyDepartment of Neurosurgery, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, And Berlin Institute of Health, GermanyDepartment of Neurosurgery, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, And Berlin Institute of Health, GermanyDepartment of Neurosurgery, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, And Berlin Institute of Health, GermanyDepartment of Neurosurgery, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, And Berlin Institute of Health, GermanyDepartment of Neurosurgery, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, And Berlin Institute of Health, GermanyDivision of Neurosurgery and Spinal Program, Toronto Western Hospital, Krembil Neuroscience Center, and University of Toronto, Toronto, CanadaSpine Tumor Program, New York University, New York, United StatesDepartment of Neurosurgery, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, And Berlin Institute of Health, GermanyDepartment of Neurosurgery, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, And Berlin Institute of Health, Germany; German Consortium for Translational Cancer Research, DKTK, Part of the German Cancer Research Centre, Berlin, GermanyIntroduction: Vertebral fractures and epidural compression are common complications in Multiple Myeloma (MM). Although non-surgical management is generally preferred, internationally accepted management guidelines are lacking. This study aimed to assess current international treatment approaches and clinical conditions guiding decision-making in MM vertebral lesions. Research question: Assessing international treatment standards for MM vertebral column lesions. Material and methods: A survey was distributed to members of the AO Spine Knowledge Forum Tumor, an expert forum specialized on the treatment of oncologic spine disease. The survey consisted of 25 questions, of which 15 assessed the participant's background, clinical expertise, and experienced treatment standards regarding MM vertebral lesions, followed by ten fictional case examples with seven possible treatment scenarios each. Results: 51 international experts completed the survey, 51 % being of orthopedic, and 44 % of neurosurgical background, while 5 % were radio-oncologists. 84 % of the participants stated they “see vertebral lesions in MM in general as a non-surgical disease”. As strongest indicators to perform surgery, neurological deficits (74 %), and potentially unstable lesions (20 %) were chosen. Clinical and radiological follow-up is performed by 83 %, however only in 46 % at defined intervals. 89 % would choose “less invasive” surgical strategies in MM than in similar lesions related to metastatic spine disease. Discussion and conclusion: The participating experts agreed towards a more restrained and less invasive management of MM patients, however the applicability of surgical scores, standards for follow-up, and indications as well as surgical strategies for MM vertebral lesions varied widely, illustrating the need for international guidelines standardizing treatment.http://www.sciencedirect.com/science/article/pii/S2772529425002061Multiple MyelomaVertebral column lesionsChronic vertebral painSurgical decision-makingInternational treatment standards |
| spellingShingle | Vanessa Hubertus Emily J. von Bronewski Lucius S. Fekonja Anton M. Früh Christian J. Entenmann Hannah Miller Charlotte Buhre Michael G. Fehlings Ilya Laufer Peter Vajkoczy Julia S. Onken Treatment approaches for multiple Myeloma vertebral column lesions – Results from an international survey distributed to the AO spine knowledge forum tumor Brain and Spine Multiple Myeloma Vertebral column lesions Chronic vertebral pain Surgical decision-making International treatment standards |
| title | Treatment approaches for multiple Myeloma vertebral column lesions – Results from an international survey distributed to the AO spine knowledge forum tumor |
| title_full | Treatment approaches for multiple Myeloma vertebral column lesions – Results from an international survey distributed to the AO spine knowledge forum tumor |
| title_fullStr | Treatment approaches for multiple Myeloma vertebral column lesions – Results from an international survey distributed to the AO spine knowledge forum tumor |
| title_full_unstemmed | Treatment approaches for multiple Myeloma vertebral column lesions – Results from an international survey distributed to the AO spine knowledge forum tumor |
| title_short | Treatment approaches for multiple Myeloma vertebral column lesions – Results from an international survey distributed to the AO spine knowledge forum tumor |
| title_sort | treatment approaches for multiple myeloma vertebral column lesions results from an international survey distributed to the ao spine knowledge forum tumor |
| topic | Multiple Myeloma Vertebral column lesions Chronic vertebral pain Surgical decision-making International treatment standards |
| url | http://www.sciencedirect.com/science/article/pii/S2772529425002061 |
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