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General questions and discussion about multiple myeloma (i.e., symptoms, lab results, news, etc.) If unsure where to post, use this discussion area.

Surgery for compressed and fractured vertebrae

by nrhayden on Tue Sep 13, 2011 8:05 pm

I would like to ask if anyone knows the time frame for having compressed or fractured vertebrae's corrected by surgery? Is there a thing as "waiting too long" to have this corrected?
My second question is there anyone that had either of the two main procedures in Louisiana?
Thank you so much!

nrhayden

Re: Surgery for compressed and fractured vertebrae

by Dr. Edward Libby on Wed Sep 14, 2011 5:58 pm

Hello,
For most patiets with compression fractures of the spine from myeloma a surgical procedure to repair a fractured or compressed vertebra is done within 1-3 months of the event. In patients with very severe, unstable fractures of the spine from myeloma (these are rare) surgical stabilization must be done within days if at all possible. If a patient has neurologic compromise (paralysis or loss of bowel or bladder control) surgery is performed with in hours or days at most...this would be an emergency.
Dr. Edward Libby
University of Washington & Fred Hutchinson Cancer Research Center

Any advice provided in these postings is based on a very limited amount of information. There is no substitute for the care of your oncologist/hematologist. Therefore, all suggestions should be discussed with your treating physician. None of the comments presented here are meant to replace the evaluation of a patient by a knowledgeable physician.


Dr. Edward Libby
Name: Edward Libby, M.D.
Beacon Medical Advisor

Re: Surgery for compressed and fractured vertebrae

by nrhayden on Thu Sep 15, 2011 6:29 pm

Thank you so much for your speedy answer.

My father had just gotten his MRI done to see if any surgery could help with his back pain. His oncologist did not ever mention that any surgery could be done for his back pain while he was under his care . His recent MRI has shown that he has multiple bulging discs (T2, T3, T6, T8, T9, T10) and Osteophyte formations in (T9, T11, T12, L1) and that his fractures have healed. Lost central height on T5 and T12.

I have read that Kyphoplasty and vertebroplasty could correct or raise these compressed fractures so the pain would be lessened (But again, I am assuming the time frame as ended for this). We are really looking for some advice on what his next step could be. His is in constant pain but does not take pain pills for various reasons. His is as active as he can be while dealing with the pain but we were hoping there would be something that could relieve some of the pain for him.

We are also hesitate to have any surgeries because the lack of knowledge of this disease in Louisiana and we believe out of state surgery will be outrageous
.
Background: He had his SCT in October of last year and is in remission, and is not on any maintenance at the present except monthly bone strengtheners.

nrhayden

Re: Surgery for compressed and fractured vertebrae

by Dr. Edward Libby on Mon Sep 19, 2011 12:28 pm

He is out of the usual time window for kyphoplasy or vertebroplasty. But, if he has severe debilitating pain perhaps he could still benefit. Only an expert in these procedures can tell you. I suspect there are good physicians performing these procedures in your state but can offer no specific recommendations.
It is not uncommon for myeloma patients to require chronic pain medications to lead a reasonable quality of life. Compressions fractures can leave a patient in permanent signficant pain (even after kyphoplasty). One option for chronic pain would be a pain patch (Duragesic) which would give him continuous pain relief 24 hours a day. These patches only need to be changed every 3 days and can simplify a patients life. The VAST majority of myeloma patients accept the need for pain meds. Without pain meds the physicians hands are really tied behind his/her back .
Dr. Edward Libby
University of Washington & Fred Hutchinson Cancer Research Center

Any advice provided in these postings is based on a very limited amount of information. There is no substitute for the care of your oncologist/hematologist. Therefore, all suggestions should be discussed with your treating physician. None of the comments presented here are meant to replace the evaluation of a patient by a knowledgeable physician.


Dr. Edward Libby
Name: Edward Libby, M.D.
Beacon Medical Advisor

Re: Surgery for compressed and fractured vertebrae

by Anonymous on Tue Sep 20, 2011 2:16 pm

Thank you again for you input. It is greatly appreciated. I will deliver the message to my mother and father and let them decide his next step in lowering his pain level.
Thanks again!

Anonymous

Re: Surgery for compressed and fractured vertebrae

by nrhayden on Thu Nov 03, 2011 4:23 pm

Hi,
Just wanted to post an uplifting update on my father. We found a local neurosurgeon and she performed kyphoplasty on my father's fractured vertebra and it was a total success. He had instant pain relief. The surgeon knew he didn't like to take pain killers and asked him to please take the loratabs after the surgery. He was a good patient and took them for the first day due to the soreness of the sight.. He was walking around the house the same day amazed. The only complication was after surgery and his bp dropped to 56/32 due to his past history of pain=passing out. We are so blessed and excited! She also sent him to get a back brace to wear when needed.
Thanks again and good luck!

nrhayden


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