Evidence map›Paper›PMID 41053490›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 Society2026

Is surgery for multiple myeloma-related spinal involvement associated with higher blood loss compared to spinal metastases?

Jens P Te Velde, Hester Zijlstra, Robertus J B Pierik, Ganesh M Shankar, Barend J van Royen, Diederik H R Kempen, Joseph H Schwab, Daniel G Tobert

Abstract readComparative Study
PubMed Publisher
In one paragraph

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, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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

1 citing paper in PubMed.

  1. Perioperative considerations for patients with multiple myeloma.European journal of anaesthesiology and intensive care · 2026
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Jens P Te VeldeDepartment of Orthopedic Surgery, Massachusetts General Hospital, 55 Fruit Street, MA, 02114, Boston, USA. jens@tevelde.amsterdam.ORCID 0009-0001-4872-1128
Hester ZijlstraDepartment of Orthopedic Surgery, Massachusetts General Hospital, 55 Fruit Street, MA, 02114, Boston, USA.
Robertus J B PierikDepartment of Orthopedic Surgery, Massachusetts General Hospital, 55 Fruit Street, MA, 02114, Boston, USA.
Ganesh M ShankarDepartment of Neurosurgery, Massachusetts General Hospital, 55 Fruit Street, MA, 02114, Boston, United States.
Barend J van RoyenDepartment of Orthopedic Surgery and Sports Medicine, Amsterdam University Medical Centers, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
Diederik H R KempenDepartment of Orthopedic Surgery, OLVG, Oosterpark 9, 1091 AC, Amsterdam, The Netherlands.
Joseph H SchwabDepartment of Orthopedic Surgery, Cedars-Sinai Medical Center, 8700 Beverly Boulevard, CA, 90048, Los Angeles, USA.
Daniel G TobertDepartment of Orthopedic Surgery, Massachusetts General Hospital, 55 Fruit Street, MA, 02114, Boston, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeMultiple myeloma (MM) is a hematologic malignancy often presenting with diffuse osteolysis of bone in the vertebral column. So far, little is known about the risk of perioperative blood loss in spinal surgery, as MM-related spinal lesions are often grouped with spinal metastases (SPMs). A more definitive understanding of bleeding risks for myeloma specifically will improve surgical planning and treatment. This study aims to assess the bleeding index (BI) and visually estimated blood loss (EBL) in MM patients versus SPM patients undergoing oncological spine surgery.

methodsIn this retrospective propensity-score-matched case-control study, we included 119 patients with MM and 119 patients with spinal metastases (SPM) who underwent oncological spine surgery between January 2002 and December 2022. A Wilcoxon signed-rank test was used to compare intraoperative bleeding values in MM and SPM patients, presented as BI and EBL.

resultsMM patients had significantly higher bleeding scores (BI 5.6) compared to SPM patients (BI 3.9) (p = 0.02). The visual EBL was significantly higher in MM patients (850 ml) compared to SPM patients (600 ml) as well (p = 0.039). The BI of MM patients was comparable to hormone-dependent breast cancer (BI 5.1) and renal cell carcinoma (BI 4.95) primary tumor types. No significant differences were found when the bleeding risk was subdivided per surgical procedure in MM (p = 0.647) or SPM patients (p = 0.403).

conclusionThis study demonstrated that the BI and EBL are significantly higher in MM compared to SPMs. MM lesions have an intraoperative bleeding risk comparable to SPMs traditionally regarded as hypervascular.

Indexed as

Blood Loss, SurgicalMultiple MyelomaSpinal NeoplasmsAgedCase-Control StudiesFemaleHumansMaleMiddle AgedPropensity ScoreRetrospective StudiesIntraoperative blood lossMultiple myelomaOncological spine surgerySpinal metastasesSpinal tumor

Identifiers

PMID41053490

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.