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经皮椎体后凸成形术治疗骨质疏松性胸腰椎压缩性骨折后残留腰痛的危险因素:一项回顾性队列研究。

Risk Factors for Residual Back Pain After PVP Treatment for osteoporotic Thoracolumbar Compression Fractures: A Retrospective Cohort Study.

机构信息

Department of Spine Surgery, The Cangzhou Hospital of Integrated TCM-WM Hebei, Cangzhou, P.R. China.

Department of Spine Surgery, The Cangzhou Hospital of Integrated TCM-WM Hebei, Cangzhou, P.R. China.

出版信息

World Neurosurg. 2023 Dec;180:e484-e493. doi: 10.1016/j.wneu.2023.09.094. Epub 2023 Sep 28.

Abstract

OBJECTIVES

To explore the risk factors of residual back pain after percutaneous vertebroplasty (PVP) in patients with osteoporotic vertebral compression fracture (OVCF).

METHODS

We retrospectively reviewed the records of 675 patients with OVCF treated with PVP from January 2015 to January 2020. Postoperative back pain intensity was assessed by the VAS score. Residual back pain was defined as the presence of postoperative moderate-severe pain (average VAS score≥4), and the variables included patient characteristics, baseline symptoms, imaging data and operation-related factors. Risk factors were identified with univariate and multivariate logistic regression analysis.

RESULTS

Residual back pain occurred in 46 of the 675 patients included in the study, with an incidence rate of 6.8%. Multivariate logistic regression analysis showed that low Pre-BMD (OR = 3.576, P = 0.041), multiple vertebral fractures (OR = 2.795, P = 0.026), posterior fascia injury (OR = 4.083, P = 0.032), cement diffusion volume rate <0.2 (OR = 3.507, P = 0.013), facet joint violation (OR = 11.204, P < 0.001), and depression (OR = 3.562, P = 0.035) were positively correlated with residual back pain after PVP.

CONCLUSIONS

Low pre-BMD (pre-bone mineral density), multiple vertebral fractures, posterior fascia injury, cement diffusion volume rate <0.2, facet joint violation and depression were the independent risk factors of residual back pain after PVP.

摘要

目的

探讨骨质疏松性椎体压缩性骨折(OVCF)患者经皮椎体后凸成形术(PVP)后残留腰痛的危险因素。

方法

回顾性分析 2015 年 1 月至 2020 年 1 月期间 675 例接受 PVP 治疗的 OVCF 患者的病历。采用视觉模拟评分(VAS)评估术后腰痛强度。残留腰痛定义为术后中重度疼痛(平均 VAS 评分≥4),并分析患者特征、基线症状、影像学资料和手术相关因素等变量。采用单因素和多因素逻辑回归分析确定危险因素。

结果

本研究共纳入 675 例患者,其中 46 例(6.8%)发生残留腰痛。多因素逻辑回归分析显示,术前骨密度(BMD)较低(OR=3.576,P=0.041)、多发椎体骨折(OR=2.795,P=0.026)、后筋膜损伤(OR=4.083,P=0.032)、骨水泥弥散体积率<0.2(OR=3.507,P=0.013)、小关节突破坏(OR=11.204,P<0.001)和抑郁(OR=3.562,P=0.035)与 PVP 后残留腰痛呈正相关。

结论

术前骨密度低(骨密度)、多发椎体骨折、后筋膜损伤、骨水泥弥散体积率<0.2、小关节突破坏和抑郁是 PVP 后残留腰痛的独立危险因素。

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