Prediction model construction of residual low back pain risk after thoracolumbar OVCF vertebroplasty
Objective To investigate the risk factors of residual low back pain risk after thoracolumbar OVCF vertebroplasty and construct related prediction model to provide reference for the follow-up clinical prevention and treatment plan.Methods 120 patients with thoracolumbar and lumbar vertebrae OVCF received vertebroplasty in our hospital from January 2021 to December 2022 were retrospectively included and were di-vided into residual group and non-residual group according to the visual analog score of lumbar and back pain 4 weeks after surgery.The independent risk factors of residual low back pain after thoracolumbar and lumbar vertebrae OVCF vertebroplasty were evaluated by univariate and multivariate methods and the prediction model was constructed based on the above factors and the clinical efficacy of the model was analyzed in predicting of residual low back pain risk after thoracolumbar OVCF vertebroplasty.Results There were 13 patients with residual low back pain in 4 weeks after surgery with the incidence of 10.83%in all 120 patients underwent vertebroplasty to treat thoracolumbar OVCF.The results of univariate analysis showed that the number of vertebral fractures,the presence or absence of intravertebral vacuum fracture,the presence or absence of posterior fascia edema,the grade of paravertebral muscle degeneration and the type of bone cement distribution may be related to the residual low back pain after thoracolumbar OVCF vertebroplasty(P<0.05).Multivariate analysis of Logistic regression model showed that multiple vertebral fractures,intravertebral vacuum fissure signs,paravertebral muscle degeneration≥Ⅲ and bone cement block distribution were independent residual risk factors for low back pain after thoracolumbar OVCF vertebroplasty(P<0.05).Based on the independent risk factors determined by multi-factor analysis,the partial regres-sion coefficient equation in predicting of residual low back pain risk after OVCF vertebroplasty was constructed:risk Logit(Y)=0.87+1.97×multi-vertebral fracture+2.74×intravertebral vacuum fracture sign+3.11×paravertebral muscle degeneration≥Ⅲ+1.50×bone cement block distribution.ROC curve analysis showed that the above clinical prediction model was significantly more effective than single risk factor in predicting the residual risk of low back pain after thoracolumbar OVCF vertebroplasty(P<0.05).Conclusion The residual low back pain after OVCF vertebroplasty may be related to many factors,including the number of vertebral fractures,the presence or absence of intravertebral vacuum fracture,the grade of par-avertebral muscle degeneration and the type of bone cement distribution and the prediction model based on the above factors showed better clinical efficacy in early and accurate identification of high-risk groups with residual low back pain after thoracolumbar OVCF vertebroplasty.
Thoracolumbar vertebraOsteoporotic vertebral compression fractureVertebroplastyResidual low back pain
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