Journal of Spine

A Case of Occipito-Thoracic Fusion for Skull Base and Cervical Multiple Myeloma

Abstract

Yu-Ichiro Ohnishi, Koichi Iwatsuki, Takashi Moriwaki, Masahiro Ishihara and Toshiki Yoshimine

Multiple myeloma is a systemic malignancy that causes bone destruction due to bone marrow infiltration. Treatment options for myeloma of the spine include radiation therapy and surgery. The case of a 59-year-old woman with multiple myeloma is reported. She was Stage 3B according to the Durie-Salmon staging system and responded to highdose chemotherapy and peripheral blood stem cell transplantation and achieved complete remission. However, her skull base and cervical bones showed marked osteolysis which required external fixation and bed rest. Surgery with occipito-thoracic (OT) fusion was performed, which yielded neurological improvement and could walk completely on her own 2 months after surgery. She had no recurrence over a 5-year follow-up period. Surgical stabilization allowed this multiple myeloma patient to remain ambulatory.