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Myeloma and Spinal Fractures

Myeloma’s impact on the structural integrity of your bones can put you at increased risk for spinal fracture. Often, spinal fractures are already present at the time of a myeloma diagnosis. If you’ve been diagnosed with myeloma, or you’ve already experienced a spinal fracture, consider talking to your doctor about the treatment options available beyond just pain management.

How Can Myeloma Increase Risk for Spinal Fractures?

Myeloma is a cancer that originates in the bone marrow from a special type of white blood cell called a plasma cell. This rare and complex disease destroys the bone marrow by replacing healthy cells with malignant plasma cells (myeloma cells).

The abnormal plasma cells travel through the bloodstream to multiple areas—most often the spine or hip—and form lesions (soft spots or holes) in the bone. These lesions erode the surrounding bone and cause structural changes that often result in spontaneous spinal fractures and pain.

The myeloma cells also disrupt the normal process of bone renewal and repair by blocking the activity of cells that repair bone (osteoblasts) and activating the cells that destroy bone (osteoclasts). On X-ray, bones affected by myeloma have holes in them, which are called "osteolytic lesions." Some myeloma patients will develop diffuse thinning of the bone instead of localized osteolytic lesions, similar to the bone affected by osteoporosis. 

What Are the Symptoms of Myeloma?

The most common symptom of myeloma is back or hip pain. More often than not, myeloma is discovered during a routine medical exam that includes blood tests. Back pain and fatigue are what bring many undiagnosed myeloma patients to the doctor in the first place.

When Should I Ask My Doctor to Check for Spinal Fracture?

If you have sudden back pain, or persistent unexplained back pain, and your doctor has not checked you for spinal fracture, it’s important to take the initiative and ask. There are treatment options available that may relieve pain and even correct spinal deformity from spinal fracture.

myeloma and spinal fracture

References:

  • Cooper C, Atkinson EJ, O’Fallon WM, Melton LJ III 1992 Incidence of clinically diagnosed vertebral fractures: A population-based study in Rochester, Minnesota, 1985-1989. J Bone Miner Res 7:221-227.