Multiple Myeloma and Epidural Spinal Cord Compression : Case Presentation and a Spine Surgeon's Perspective
A 62-year-old woman was presented with upper back pain and progressive weakness for one month. On her history, she had undergone posterior spine surgery for a multiple compression fracture 6 months ago. She denied hearing about multiple myeloma at that surgery. Laboratory and radiological tests revealed multiple myeloma (IgG, κ chain). MRI showed multiple pathological fracture involving T4, 7, and 9 and an epidural mass was compressing the spinal cord at the T4 level. On neurological examination, her lower extremity motor power was over grade IV and she was able to walk unaided (Frankel D), even though she complained of lower extremity weakness. High-dose steroid and fractioned radiotherapy were performed. A radiological examination conducted 3 months post-radiotherapy revealed complete resolution of the cord compression and disappearance of the epidural mass (). No further pathological fracture were found. At the 18 month follow-up, her neurological status had improved with mild discomfort over the upper back region.