What Is a Compressive Fracture Multiple Myeloma?

Multiple myeloma is a rare cancer that affects the plasma cells of the bone marrow. It replaces healthy marrow with malignant plasma, leading to weakened bones and an impaired immune system. It causes pain, especially in the back and ribs, which is usually how the disease is discovered.

Function

• In multiple myeloma, osteolytic lesions form from the marrow to the outside of the bone. These are soft spots in the bones, showing up on X-rays as holes, which lead to bone weakness that easily fractures.

Significance

• Approximately 75 percent of myeloma patients experience bone pain and orthopedic interventions are aimed at controlling pain and retaining function and mobility. Most bone pain is in the spine.

Types

• Vertebral compression fractures are common with myeloma and occur when the vertebrae fractures or collapses because the weakened bone cannot stand up to the stress and pressure placed on it.

Effects

• Vertical compression fractures cause the spine to shorten and become misaligned, leading to a "hunched back" appearance known as kyphosis. Quality of life is impacted, as the condition is painful. Loss of mobility is typical along with other complications, such as reduced chest and abdominal space causing lowered lung function and loss of appetite.

Treatment

• VCF in multiple myeloma is typically treated with pain relief medications, often nonsteroidal anti-inflammatory agents, as well as radiation therapy for pain relief and bisphosphonates, or drugs that bind to the bone surface and inhibit bone breakdown and pain. Also, doctors often perform minimally invasive surgical procedures such as vertebroplasty, where bone cement is injected into the collapsed vertebrae; and balloon kyphoplasty, where orthopedic balloons are used to create a space before bone cement is applied.