{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T16:46:55Z","timestamp":1787849215880,"version":"build-2784847793"},"reference-count":30,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["SPI"],"published-print":{"date-parts":[[2015,3]]},"abstract":"<jats:sec>\n<jats:title>OBJECT<\/jats:title>\n<jats:p>Multiple myeloma is the most common primary tumor of the spine and is the most common primary malignant tumor of bone. Although spinal myeloma is classically a radiosensitive lesion, clinical or radiographic signs of instability merit surgical intervention. The authors present the epidemiology, surgical indications, and outcome data of a series of consecutive cases involving 31 surgically treated patients with diagnoses of multiple myeloma and plasmacytoma of the spine (the largest such series reported to date).<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>Surgical instability was the criterion for operative intervention in this patient cohort. The Spinal Instability Neoplastic Score (SINS) was used to make this assessment of instability. The cases were analyzed using location of the lesion, spinal levels involved, Frankel score, adjuvant therapy, functional outcome, and patient survival.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>All patients undergoing surgical intervention were determined to have indeterminate or gross spinal column instability according to SINS criteria. The median survival was 78.9 months. No significant difference in survival was seen for patients with higher SINS scores or for older patients (&gt; 55 years). There was a statistically significant difference in survival benefit observed for patients receiving chemotherapy and radiation versus radiation alone as an adjuvant to surgery (p = 0.02).<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>In this 10-year analysis, the authors report outcomes of surgical intervention for patients with indeterminate or gross spinal instability due to multiple myeloma and plasmacytoma of the spine with improved neurological function following surgery and low rates of instrumentation failure.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2014.9.spine14554","type":"journal-article","created":{"date-parts":[[2015,1,9]],"date-time":"2015-01-09T15:04:24Z","timestamp":1420815864000},"page":"301-309","source":"Crossref","is-referenced-by-count":62,"title":["Outcomes following surgical intervention for impending and gross instability caused by multiple myeloma in the spinal column"],"prefix":"10.3171","volume":"22","author":[{"given":"Patricia L.","family":"Zadnik","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. Rory","family":"Goodwin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristophe J.","family":"Karami","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ankit I.","family":"Mehta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anubhav G.","family":"Amin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mari L.","family":"Groves","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Paul","family":"Wolinsky","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy F.","family":"Witham","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Bydon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ziya L.","family":"Gokaslan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel M.","family":"Sciubba","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-spine14554","series-title":"N Engl J Med","doi-asserted-by":"publisher","first-page":"1657","DOI":"10.1056\/NEJM199706053362307","article-title":"Multiple myeloma","volume":"336","author":"Bataille","year":"1997"},{"key":"b2-spine14554","series-title":"Cancer","doi-asserted-by":"publisher","first-page":"845","DOI":"10.1002\/1097-0142(19810801)48:3<845::AID-CNCR2820480330>3.0.CO;2-E","article-title":"Solitary myeloma: clinical and prognostic features of a review of 114 cases","volume":"48","author":"Bataille","year":"1981"},{"key":"b3-spine14554","series-title":"Int J Radiat Oncol Biol Phys","doi-asserted-by":"publisher","first-page":"329","DOI":"10.1016\/S0360-3016(96)00334-3","article-title":"Solitary plasmacytoma of bone and soft tissue","volume":"36","author":"Bolek","year":"1996"},{"key":"b4-spine14554","series-title":"J Clin Oncol","doi-asserted-by":"publisher","first-page":"1811","DOI":"10.1200\/JCO.1987.5.11.1811","article-title":"Solitary plasmacytoma of bone: treatment, progression, and survival","volume":"5","author":"Chak","year":"1987"},{"key":"b5-spine14554","series-title":"Intern Med J","doi-asserted-by":"publisher","first-page":"211","DOI":"10.1111\/j.1445-5994.2005.00804.x","article-title":"Radiotherapy in the management of solitary extramedullary plasmacytoma","volume":"35","author":"Chao","year":"2005"},{"key":"b6-spine14554","series-title":"Rev Chir Orthop Reparatrice Appar Mot","first-page":"311","article-title":"[Surgical treatment of myeloma localized in the spine]","volume":"84","author":"Chataigner","year":"1998"},{"key":"b7-spine14554","series-title":"Arch Orthop Trauma Surg","doi-asserted-by":"publisher","first-page":"463","DOI":"10.1007\/BF00387578","article-title":"Surgical treatment for myeloma of the bone. A retrospective analysis of 22 cases","volume":"116","author":"D\u00fcrr","year":"1997"},{"key":"b8-spine14554","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"320","DOI":"10.1097\/00007632-200202010-00023","article-title":"Multiple myeloma: surgery of the spine: retrospective analysis of 27 patients","volume":"27","author":"D\u00fcrr","year":"2002"},{"key":"b9-spine14554","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"E1221","DOI":"10.1097\/BRS.0b013e3181e16ae2","article-title":"A novel classification system for spinal instability in neoplastic disease: an evidence-based approach and expert consensus from the Spine Oncology Study Group","volume":"35","author":"Fisher","year":"2010"},{"key":"b10-spine14554","series-title":"J Clin Oncol","doi-asserted-by":"publisher","first-page":"3072","DOI":"10.1200\/JCO.2010.34.3897","article-title":"Spinal instability neoplastic score: an analysis of reliability and validity from the spine oncology study group","volume":"29","author":"Fourney","year":"2011"},{"key":"b11-spine14554","series-title":"Int J Radiat Oncol Biol Phys","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1016\/0360-3016(89)90008-4","article-title":"Solitary plasmacytoma of bone: Mayo Clinic experience","volume":"16","author":"Frassica","year":"1989"},{"key":"b12-spine14554","series-title":"Ann Oncol","doi-asserted-by":"publisher","first-page":"687","DOI":"10.1093\/oxfordjournals.annonc.a059285","article-title":"Solitary plasmacytoma of bone and extramedullary plasmacytoma: two different entities?","volume":"6","author":"Galieni","year":"1995"},{"key":"b13-spine14554","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"599","DOI":"10.3171\/jns.1998.89.4.0599","article-title":"Transthoracic vertebrectomy for metastatic spinal tumors","volume":"89","author":"Gokaslan","year":"1998"},{"key":"b14-spine14554","series-title":"Handbook of Neurosurgery","year":"2010"},{"key":"b15-spine14554","series-title":"Oncologist","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1634\/theoncologist.12-1-20","article-title":"Cancer statistics, trends, and multiple primary cancer analyses from the Surveillance, Epidemiology, and End Results (SEER) Program","volume":"12","author":"Hayat","year":"2007"},{"key":"b16-spine14554","series-title":"Zhonghua Bing Li Xue Za Zhi","first-page":"307","article-title":"[Solitary plasmacytoma of spine: a clinical, radiologic and pathologic study of 13 cases]","volume":"38","author":"He","year":"2009"},{"key":"b17-spine14554","series-title":"Cancer","doi-asserted-by":"publisher","first-page":"1513","DOI":"10.1002\/1097-0142(19920315)69:6<1513::AID-CNCR2820690633>3.0.CO;2-X","article-title":"Plasmacytoma. Treatment results and conversion to myeloma","volume":"69","author":"Holland","year":"1992"},{"key":"b18-spine14554","series-title":"Zhonghua Wai Ke Za Zhi","first-page":"697","article-title":"[Surgical intervention and radiotherapy outcome of solitary plasmacytoma of cervical spine]","volume":"48","author":"Huang","year":"2010"},{"key":"b19-spine14554","series-title":"Eur J Cancer","doi-asserted-by":"publisher","first-page":"363","DOI":"10.1016\/0277-5379(90)90235-L","article-title":"Prognostic significance of osteopenia and immunoparesis at presentation in patients with solitary myeloma of bone","volume":"26","author":"Jackson","year":"1990"},{"key":"b20-spine14554","series-title":"Acta Orthop Scand","doi-asserted-by":"publisher","first-page":"192","DOI":"10.3109\/17453679209154821","article-title":"Surgery for multiple myeloma of the spine. A retrospective analysis of 12 patients","volume":"63","author":"J\u00f3nsson","year":"1992"},{"key":"b21-spine14554","series-title":"Eur J Cancer","first-page":"1865","article-title":"Surgical treatment of myeloma of bone","volume":"28A","author":"Kivioja","year":"1992"},{"key":"b22-spine14554","series-title":"BMC Cancer","doi-asserted-by":"publisher","first-page":"118","DOI":"10.1186\/1471-2407-6-118","article-title":"Prognostic factors in solitary plasmacytoma of the bone: a multicenter Rare Cancer Network study","volume":"6","author":"Knobel","year":"2006"},{"key":"b23-spine14554","series-title":"J Clin Oncol","doi-asserted-by":"publisher","first-page":"255","DOI":"10.1200\/JCO.1983.1.4.255","article-title":"Comparison of extramedullary plasmacytomas with solitary and multiple plasma cell tumors of bone","volume":"1","author":"Knowling","year":"1983"},{"key":"b24-spine14554","series-title":"Zhonghua Wai Ke Za Zhi","first-page":"48","article-title":"[Surgery for multiple myeloma of the bone]","volume":"42","author":"Li","year":"2004"},{"key":"b25-spine14554","series-title":"Int J Radiat Oncol Biol Phys","doi-asserted-by":"publisher","first-page":"1063","DOI":"10.1016\/S0360-3016(98)00186-2","article-title":"Solitary bone plasmacytoma: outcome and prognostic factors following radiotherapy","volume":"41","author":"Liebross","year":"1998"},{"key":"b26-spine14554","series-title":"Int J Radiat Oncol Biol Phys","doi-asserted-by":"publisher","first-page":"210","DOI":"10.1016\/j.ijrobp.2005.06.039","article-title":"Outcomes and patterns of failure in solitary plasmacytoma: a multicenter Rare Cancer Network study of 258 patients","volume":"64","author":"Ozsahin","year":"2006"},{"key":"b27-spine14554","series-title":"Acta Medica (Hradec Kralove) Suppl","first-page":"37","article-title":"[Indication and radicality of surgical treatment in spinal myeloma]","volume":"48","author":"Reh\u00e1k","year":"2005"},{"issue":"Suppl 2","key":"b28-spine14554","series-title":"Vnitr Lek","first-page":"32","article-title":"[Surgical options in the treatment of myeloma of the spine]","volume":"52","author":"Repko","year":"2006"},{"key":"b29-spine14554","series-title":"Br J Cancer","doi-asserted-by":"publisher","first-page":"128","DOI":"10.1038\/bjc.1995.26","article-title":"Localised plasmacytomas in Taiwan: comparison between extramedullary plasmacytoma and solitary plasmacytoma of bone","volume":"71","author":"Shih","year":"1995"},{"key":"b30-spine14554","series-title":"Int Orthop","doi-asserted-by":"publisher","first-page":"1209","DOI":"10.1007\/s00264-010-1127-0","article-title":"Surgical therapy of skeletal complications in multiple myeloma","volume":"35","author":"Utzschneider","year":"2011"}],"container-title":["Journal of Neurosurgery: Spine"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/22\/3\/article-p301.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/22\/3\/article-p301.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/22\/3\/article-p301.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,15]],"date-time":"2023-04-15T21:29:00Z","timestamp":1681594140000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/22\/3\/article-p301.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,3]]},"references-count":30,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.3171\/2014.9.spine14554","relation":{},"ISSN":["1547-5654"],"issn-type":[{"value":"1547-5654","type":"print"}],"subject":[],"published":{"date-parts":[[2015,3]]}}}