Evidence map›Paper›PMID 40285842›Full record

ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2025

Changes in sagittal spinopelvic alignment are associated with increased pain and impaired function in multiple myeloma patients.

Julian Kylies, Michael Dirks, Elias Brauneck, Marlon Tessarzyk, Marc Dreimann, Andre Strahl, Wanja Wolters, Katja Weisel, Leon-Gordian Leonhardt, Lennart Viezens

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Article in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors.

Julian KyliesDepartment of Trauma and Orthopedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany, Hamburg, Germany. j.kylies@uke.de.
Michael DirksTrauma surgery, Orthopaedics and Sports Traumatology, BG Clinic Hamburg, Hamburg, Germany.
Elias BrauneckDepartment of Trauma and Orthopedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany, Hamburg, Germany.
Marlon TessarzykDepartment of Trauma and Orthopedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany, Hamburg, Germany.
Marc DreimannDepartment of Trauma and Orthopedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany, Hamburg, Germany.
Andre StrahlDepartment of Trauma and Orthopedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany, Hamburg, Germany.
Wanja WoltersTrauma surgery, Orthopaedics and Sports Traumatology, BG Clinic Hamburg, Hamburg, Germany.
Katja WeiselDepartment of Oncology, Hematology and Bone Marrow Transplantation with Section Pneumology, Hubertus Wald University Cancer Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany, Hamburg, Germany.
Leon-Gordian Leonhardt *Department of Trauma and Orthopedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany, Hamburg, Germany.
Lennart Viezens *Department of Trauma and Orthopedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany, Hamburg, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeMultiple myeloma (MM), a type of B-cell non-Hodgkin lymphoma, frequently causes osteolytic spinal lesions, increasing the risk of fracture and poor sagittal spinopelvic alignment. In relapsed patients, these changes may contribute to increased pain and functional impairment.

methodsThe clinical data of 86 MM patients (48 males, 38 females) who underwent ≥ 3 whole-body CT scans between 2009 and 2024, with a mean interscan interval of 19.2 months and a total follow-up duration of 37.5 months, were analyzed in this retrospective study. Spinopelvic parameters were measured, and clinical data (pain intensity, analgesic use, ECOG classification, and ASIA classification) were assessed.

resultsOver the disease course, thoracic kyphosis (TK) increased significantly (from 38.5° to 46.7°, p < 0.0001), whereas the Dens axis-S1 distance decreased (from 53.2 cm to 49.3 cm, p < 0.0001). These changes correlated with increased pain levels (median VAS score increasing from 2.0 to 6.0, p < 0.0001) and increased analgesic use (median WHO analgesic level increasing from 1.0 to 3.0, p < 0.001). Other spinopelvic parameters remained stable, and no significant changes were observed in the ECOG or ASIA classifications. Notably, an increase in TK exceeding nine degrees was strongly associated with increased pain levels (mean VAS score of 7.3 vs. 4.9, p < 0.001), whereas new vertebral fractures did not significantly impact pain intensity or analgesic consumption.

conclusionIn MM patients, progressive TK and a reduced Dens axis-S1 distance are key contributors to worsening pain and increased analgesic requirements. Surgical strategies should prioritize kyphosis correction, particularly in cases where increases in TK exceeding nine degrees, to optimize pain management. Future studies should further explore these findings.

Indexed as

KyphosisMultiple MyelomaPainAdultAgedAged, 80 and overFemaleHumansMaleMiddle AgedPain MeasurementRetrospective StudiesTomography, X-Ray ComputedKyphosisLordosisMultiple myelomaPainSpinal fracture

Identifiers

PMID40285842

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