Myeloma/Plasmacytoma

The human spine is formed by individual vertebrae and connective tissue discs in between. The vertebrae form the spinal canal. There are seven cervical, twelve thoracic, and five lumbar vertebrae. The intervertebral discs are the link between the individual vertebral bodies.

The little joints that link the vertebrae together are known as facet joints. They help to stabilize the spine and, together with the intervertebral discs, allow a certain degree of mobility of the spinal cord. The spinal canal should be wide enough to allow nerve roots to float freely in cerebrospinal fluid. The front border of the spinal canal is built by the vertebral bodies and intervertebral discs, the side by the intervertebral joints (facets) and back by the ligamentum flavum (yellow band) and vertebral arches. Discs consist of an outer fibrous ring (annulus fibrosus), which surrounds an inner gel-like center (nucleus pulposus). The spinal cord and nerve roots lie within the spinal canal. The spinal cord extends downwards approx. to the 1st lumbar vertebra. Below, only nerve roots are present in the spinal canal. At the level of the intervertebral disc the nerve roots pass through the neural root foramina to exit the spinal canal. The spinal cord and nerve roots conduct electric-like signals from the skin and joints to the brain, and process of movement is initiated from the brain to the muscles.

Plasmacytoma is one of the most common malignant tumors of the spine. It occurs most often after the 5th decade. The tumor is due to an uncontrollable increase in the number of plasmocytes (immune cells precursors). The tumor causes degradation (osteolysis) and weakening of the affected bone. The increasing numbers of tumor cells replace normal blood cells, leading to anemia and susceptibility to infections. The most frequent localization of this tumor is in the spine, ribs, collarbone, skull, pelvis and femur. When only one tumor is present, it is called plasmacytoma, when multiple are present, it is called multiple Myeloma. Multiple Myeloma/Plasmacytoma usually is preceded by a benign condition called monoclonal gammopathy, a condition of undetermined significance.

Acute compression of the spinal cord and/or nerve roots

Vertebral fracture

Severe back pain

Pain, numbness and weakness in the limbs

Unsteady gait (especially in dark rooms) Stiffness, numbness and weakness of the hands and legs Retention, or unintended urinary incontinence Numbness of the genitals and loss of sexual function

Usually treatment is surgical

Complete tumor removal

Obtaining material for histological examination

To release the compressed nerve roots and/or spinal cord

To preserve the protective function of the spine

Posterior decompression of the spinal canal with stabilisation