2023DGOU多学科建议：多发性骨髓瘤患者病理性胸腰椎骨折的管理

Check for updatesSpecial Issue ArtideDG0小8Global Spine Joumal2023.VoL131S)85S-93SManagement of Pathological Thoracolumbar©The Author()s2022Article reuse guidelines:Vertebral Fractures in Patients With Multiplesagepub.com/journals-permissionsD0L10117721925682221143732Myeloma:Multidisciplinaryjournals.sagepub.com/home/gsjSAGERecommendationsGeorg Osterhoff',Michael Kreinest2,Thomas Kuhnt3,Claudia Pohlenz3,Jacques Muiller-Broich,Christoph Rolligs,Raphael Teipel,Max J.Scheyerers,Klaus John Schnake7.8,Ulrich J.A.Spiegl',Alexander C.Disch,and the Spine Section ofthe German Society for Orthopaedics and Trauma(DGOU)AbstractStudy Design:Mutlidisciplinary consensus recommendations for patients suffering from multiple myeloma(MM)involvementof the spinal column by the Spine Section of the German Association of Orthopaedic and Trauma Surgeons.Objective:To provide a comprehensive multidisciplinary diagnostic and therapeutic approach and to summarize the currentliterature on the management of pathological thoracolumbar vertebral fractures in patients with multiple myeloma.Methods:Multidisciplinary recommendations using a classical consensus process provided by radiation oncologists,medicaloncologists,orthopaedic-and trauma surgeons.A narrative literature review of the current diagnostic and treatment strategieswas conducted.Results:Treatment decision has to be driven by a multidisciplinary team of oncologists,radiotherapists and spine surgeons.When considering surgery in MMpatients,differing factors compared to other secondary spinal lesions have to be included intothe decision process:probable neurological deterioration,the stage of the disease and prognosis,patient's general condition,localization and number of the lesions as well as patient's own wishes or expectations.Aiming to improve quality of life,themajor goal of surgical treatment is to preserve mobility by reducing pain,secure neurological function and stability.Conclusion:The goal of surgery is primarily to improve quality of life by restoring stability and neurological function.In-terventions with an increased risk of complications due to MM-associated immunodeficiency must be avoided whenever feasibleDepartment of Orthopaedics,Trauma and Plastic Surgery.University Hospital Leipzig Leipzig Germany2 Spine Center,BG Clinic Ludwigshafen,Ludwigshafen,Germany3Department of Imaging and Radiation Medicine.Clinic of Radiooncoly.University of Leipzig Leipzig GermanyOrthopedic University Hospital Friedrichsheim,Frankfurt,Germanys Medizinische Klinik und Poliklinik I,Universitatsklinikum,Carl Gustav Carus,Technische Universitat Dresden,Dresden,Germany6Department of Orthopaedics and Trauma Surgery.University Hospital Duesseldorf,Duesseldorf.Germany7Center for Spinal and Scoliosis Surgery.Malteser Waldkrankenhaus St.Marien,Erlangen.Germanya Department of Orthopedics and Traumatology.Paracelsus Private Medical University Nuremberg.Nuremberg.GermanyUniversity Comprehensive Spine Center.University Center for Orthop