Dear all,
Wanted to share another successful spine surgery on a Multiple myeloma patient. This patient was referred to me by Medical oncologist for paraparesis and decreased sensation below his umbilical region 1 month back. He was finding it difficult to walk and to do his routine day to day activities. MRI done on 2020 showed D12 wedge compression fracture with no canal stenosis or root compression. Since his current clinical examination finding did not co-relate with the old MRI, a repeat imaging was done which showed D11 and D12 collapsed vertebra with significant cord/ root compression. There were myelomalacia changes also. He was suggested surgical stabilization of spine. After much deliberation ans discussion he was admitted last Friday for surgery. He underwent D9 D10, L1 L2 pedicle screw stabilization with titanium screws and rods. a complete decompression of cord from D9 to L2 was done. Patient is relieved of his paraparesis and ambulant alone without support in an erect posture. He was discharged yesterday.
Problem with Multiple myeloma is the bone is very porous and the chance for biomechanical failiure is very high due to intra operative pedicle fracture or screw breakage. This was overcome by using Dual threaded screws which offer good stabilization and cortical fixation.