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Radiation May Be All That's Needed for Cervical Spine Metastase

Posted on: 08/31/2006
In this report, the authors present the results of a series of patients treated for multiple myeloma. Each patient had metastases or cancer that had spread to the cervical spine (neck). Symptoms included pain and spinal instability. Treatment consisted of radiation and/or surgery.

Outcomes of treatment were measured by change in pain, presence of neurologic symptoms, and results of X-rays. X-rays showed if there was any spinal instability. Instability was seen as destruction of the bone and collapse of vertebral bodies. Any deformity caused by these changes was also noted.

Thirty-five (35) patients with cervical spine metastases from multiple myeloma were included. Patients ranged in age from 35 years old to 82 years. Everyone was treated at the M. D. Anderson Cancer Center in Houston, Texas.

Most of the patients (77 per cent) had radiation alone. The rest had radiation and surgery, radiation after surgery, or just surgery. Most of the operations were to fuse the spine. Everyone wore a neck collar to immobilize the neck for at least three months.

Almost all of the patients in all the treatment groups had relief of their pain. The authors point out that significant pain relief was possible with radiotherapy alone. Radiation was able to stop the bone destruction. In some cases, bone healing and bone remodeling took place.

Many patients with terminal cancer have spinal metastases. It is helpful to know that radiation can help reduce pain and stabilize the cervical spine when it is affected in this way. Treatment may be able to prevent fractures and deformity leading to an unstable cervical spine. Surgery may not be needed after all.

Ganesh Rao, MD, et al. Multiple Myeloma of the Cervical Spine: Treatment Strategies for Pain and Spinal Instability. In Journal of Neurosurgery: Spine. August 2006. Vol. 5. No. 2. Pp. 140-145.

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