Factors influencing residual low back pain after vertebral augmentation for treatment of osteoporotic vertebral compression fracture
Objective:To analyze the factors influencing residual low back pain(LBP)after vertebral augmentation for treatment of os-teoporotic vertebral compression fracture(OVCF).Methods:The medical records of patients who underwent vertebral augmentation for treatment of OVCF were retrospectively analyzed.The information of the enrolled patients,including gender,age,body mass,whether com-bined with diabetes mellitus,hypertension,Kümmell's disease,and postoperative vertebral infection,spinal trauma history,operation me-thod,consumption and distribution of bone cement,preoperative and postoperative year-1 vertebral height compression ratio and kyphosis Cobb's angle,as well as whether presence of residual LBP at postoperative year-1,was extracted from the Electronic Medical Record System(EMRS).The included patients were divided into postoperative residual LBP group and postoperative non-residual LBP group based on whether the residual LBP was found at postoperative year-1.The single-factor analysis was conducted on the extracted information for screening the factors affecting residual LBP,followed by multi-factor logistic regression analysis on the screened factors for identifying the factors influencing residual LBP after vertebral augmentation for OVCF.Results:Six hundred and two patients were enrolled in the study,52 ones in postoperative residual LBP group and 550 ones in postoperative non-residual LBP group.The differences were statistically signifi-cant between the 2 groups in spinal trauma history,whether combined with Kümmell's disease,consumption of bone cement,distribution of bone cement,postoperative year-1 vertebral height compression ratio and kyphosis Cobb's angle(x2=16.062,P=0.000;x2=6.453,P=0.011;3.65±0.70 vs 4.25±0.94 mL,t=-2.249,P=0.031;x2=12.366,P=0.000;30.93±3.97 vs 23.21±4.02％,t=6.917,P=0.000;12.41±3.69 vs 6.82±2.63 degrees,t=0.065,P=0.000).The results of multi-factor logistic regression analysis showed that combined Kümmell's disease,suboptimal bone cement distribution,a greater vertebral height compression ratio at postoperative year-1,and a larger kyphosis Cobb's angle at postoperative year-1 were the risk factors for persistence of LBP at 1 year after vertebral augmentation for OVCF(β=1.682,P=0.031,OR=0.153;β=0.893,P=0.047,OR=2.202;β=0.635,P=0.014,OR=0.359;β=0.721,P=0.040,OR=0.762).Conclusion:Combined Kümmell's disease,suboptimal bone cement distribution,and poor correction of postoperative verte-bral height and kyphotic deformity are the risk factors for residual LBP after vertebral augmentation in patients with OVCF.
low back painback painosteoporotic fracturesspinal fracturesfractures,compressionvertebroplastykyphoplasty
NETL
NSTL
万方数据
