Compressive Myeloradiculopathies in Multiple Myeloma: Clinical and Radiological Characteristics of a Series of 29 Patients

Introduction: Patients with multiple myeloma (MM) develop neurological complications such as root and/or spinal cord compression in at least 5% of cases. The aim of this work is to describe the clinical and radiological features of root and/or spinal cord compression occurring during multiple myeloma. Patients and Methods: We conducted a retrospective study in the Clinical Haematology Department of Dalal Jamm Hospital and the National Blood Transfusion Centre, the Neurological Clinic of Fann Hospital Centre and the Internal Medicine Department of Aristide Le Dantec Hospital in Dakar between January 2016 and December 2019. All patients whose multiple myeloma diagnosis was established according to the International Myeloma Working Group’s 2014 and who had root, spinal or myeloradicular compression, were included in our study. Results: A total of 29 patients were included. The average age was 54.31 years [32 - 76 years]. The sex ratio (M/F) was 1.6. Motor deficits were the reason for consultation in 68% of the patients and spinal pains were reported by 93% of the patients. Neurological signs revealed multiple myeloma in all our patients. 25 patients (86.2%) had paraplegia and 1 patient had tetraparesis. Hypoesthesia to a defined sensory level was noted in 8 patients (28%). 5 patients (17.24%) had sphincter disorders. The types of lesions showed by imaging were vertebral lysis in 100% of cases, vertebral compression in 37% of cases, and epidural infiltration in 34% of cases. 12 patients (41.37%) had spinal compression, 14 patients (48.27%) had root compression, and 3 patients (10.34%) had myeloradicular compression. Spinal cord compression was most often at the dorsolumbar level (91.3% of cases) and root compression was mainly located in the lumbar spine (76.47% of cases). Conclusion: Spinal and root compressions are common complications of multiple myeloma, often revealing the disease in our context. The dorsolumbar level was most often of interest in our study.