TITLE:
Compressive Myeloradiculopathies in Multiple Myeloma: Clinical and Radiological Characteristics of a Series of 29 Patients
AUTHORS:
El Hadji Daouda Niang, Mbodji Ahmadou Bamba, Ka Mamadou, Fall Seynabou, Seck Moussa, Mbaye Khalifa Ababacar, Bousso Elimane, Sarr Khadim, Faye Atoumane, Ndiaye Fatou Samba Diago, Ndiaye Moustapha, Diop Saliou
KEYWORDS:
Multiple Myeloma, Spinal Cord Compression, Root Compression, Bone Lesions
JOURNAL NAME:
Open Journal of Blood Diseases,
Vol.11 No.4,
December
2,
2021
ABSTRACT: Introduction: Patients with multiple myeloma (MM) develop neurological complications such as root and/or spinal cord
compression in at least 5% of cases. The aim of this work is to describe the
clinical and radiological features of root and/or spinal cord compression occurring
during multiple myeloma. Patients and Methods: We conducted
a retrospective study in the Clinical Haematology Department of Dalal Jamm
Hospital and the National Blood Transfusion Centre, the Neurological Clinic of
Fann Hospital Centre and the Internal Medicine Department of Aristide Le Dantec
Hospital in Dakar between January 2016 and December 2019. All patients whose
multiple myeloma diagnosis was established according to the International
Myeloma Working Group’s 2014 and who had root, spinal or myeloradicular
compression, were included in our study. Results: A total of 29 patients
were included. The average age was 54.31 years [32 - 76 years]. The sex ratio
(M/F) was 1.6. Motor deficits were the reason for consultation in 68% of the
patients and spinal pains were reported by 93% of the patients. Neurological
signs revealed multiple myeloma in all our patients. 25 patients (86.2%) had
paraplegia and 1 patient had tetraparesis. Hypoesthesia to a defined sensory
level was noted in 8 patients (28%). 5 patients (17.24%) had sphincter
disorders. The types of lesions showed by imaging were vertebral lysis in 100%
of cases, vertebral compression in 37% of cases, and epidural infiltration in
34% of cases. 12 patients (41.37%) had spinal compression, 14 patients (48.27%)
had root compression, and 3 patients (10.34%) had myeloradicular compression.
Spinal cord compression was most often at the dorsolumbar
level (91.3% of cases) and root compression was mainly located in the lumbar spine (76.47% of cases). Conclusion: Spinal and root compressions are common complications of multiple myeloma,
often revealing the disease in our context. The dorsolumbar level was
most often of interest in our study.