2022, Vol. 26 ›› Issue (18): 2900-2905

Risk factors of residual pain after percutaneous vertebral augmentation for osteoporotic thoracolumbar compression fractures

Liu Chen1, 2, Hu Chengzhe1, 2, Yin Xun2, 3, Yu Ziheng2, 3, Yang Jiandong2   

Abstract: BACKGROUND: Residual pain after percutaneous vertebral augmentation is one of the serious complications affecting the quality of life of patients, and also a difficult problem for clinicians. At present, some studies have analyzed the risk factors of residual pain after vertebral body strengthening, but they are not comprehensive and the mechanism is not clear.   
OBJECTIVE: To analyze the risk factors of residual pain after vertebral body strengthening in osteoporotic thoracolumbar compression fractures, and to explore its mechanism.
METHODS:   A total of 217 patients with osteoporotic vertebral compression fractures who received percutaneous vertebral augmentation in the Department of Spinal Surgery, Northern Jiangsu People’s Hospital from October 2019 to January 2021 were selected. Postoperative residual pain was considered if the visual analogue scale score was ≥4 at 1 week, 1, 3, and 6 months after surgery. According to whether there was residual pain, patients were divided into residual pain group (n=33) and no residual pain group (n=184). Gender, age, body mass index, the course of the disease, chronic medical history, history of trauma, vertebral fracture site, history of low back pain, lumbodorsal fascia injury, bone mineral density, adjacent vertebral fractures, surgical procedure, amount of bone cement, bone cement leakage, preoperative vertebral height compression rate, postoperative vertebral height recovery rate, and improvement rate of postoperative Cobb angle were surveyed between the two groups. Univariate and multivariate Logistic regression analyses were used to investigate the risk factors of postoperative residual pain.
RESULTS AND CONCLUSION: (1) There was no significant difference in gender, age, course of disease, chronic history, vertebral fracture site, surgical method, amount of bone cement, bone cement leakage, and preoperative vertebral height compression rate between the two groups (P > 0.05). (2) There were statistically significant differences in body mass index, trauma history, lumbodorsal fascia injury, history of low back pain, bone mineral density, adjacent vertebral fracture, postoperative vertebral height recovery rate, and improvement rate of postoperative Cobb angle between the two groups (P < 0.05). (3) Logistic regression analysis showed that body mass index, lumbodorsal fascia injury, bone mineral density, adjacent vertebral fractures, postoperative vertebral height recovery rate, and improvement rate of postoperative Cobb angle were the risk factors for postoperative residual low back pain (P < 0.05). (4) The results showed that body mass index, lumbodorsal fascia injury, bone mineral density, adjacent vertebral fractures, postoperative vertebral height recovery rate, and improvement rate of postoperative Cobb angle were the risk factors for postoperative residual pain. Corresponding preventive measures should be taken in clinical work to reduce the occurrence of postoperative residual pain.
Key words: osteoporosis, vertebral fracture, vertebral augmentation, bone cement, residual pain, complications, risk factors, tissue engineering