Liu Zhen-Gang, Yang Fan, Li Peng-Fu, Song Qi, Wang Gao, Zhang Bo-Yin
Department of Orthopaedics, China-Japan Union Hospital of Jilin University, Changchun, 130033, China.
BMC Musculoskelet Disord. 2025 Feb 3;26(1):110. doi: 10.1186/s12891-025-08358-9.
This study aims to investigate the associated factors of intercostal neuralgia in patients with osteoporotic vertebral compression fractures (OVCF) of the thoracic spine and to develop a predictive model to assess the likelihood of patients developing intercostal neuralgia following thoracic vertebral fractures.
The retrospective study involved 518 patients with thoracic OVCF treated at our hospital, among whom those with and without intercostal neuralgia were matched at a 1:1 ratio.Relevant basic clinical data and imaging parameters of the patients were recorded, t-test was used for continuous variables and chi-square test for categorical variables to determine the factors associated with intercostal neuralgia. Subsequently, the above associated variables were screened using univariate and multivariate logistic regression models to obtain associated factors. Finally, a prediction model for osteoporotic thoracic spine fracture was developed and validated.
This study included a total of 104 patients based on the presence or absence of intercostal neuralgia.The results of multifactorial logistic regression analysis showed that injured vertebral intervertebral foraminal area (P = 0.0008, regression coefficient estimate 0.0490, 95% confidence interval 0.0219-0.0798, OR = 1.0503), injured vertebral intervertebral foraminal volume (P = 0.0001, regression coefficient value - 0.0028, 95% confidence interval - 0.0044 to -0.0015, OR = 0.9972), and nerve root area (P = 0.0038, regression coefficient estimate=-0.0876, 95% confidence interval - 0.1506 to -0.0309, OR = 0.9161) were independent associated factors.The fatty degeneration ratio have a positive promotional effect on the probability of developing intercostal pain.The area under the ROC curve (AUC) of the prediction model was 0.851, which indicated that the line graph model had a certain degree of predictive validity.
Thoracic osteoporotic fractures are a common geriatric disease, and changes in the morphological parameters of the intervertebral foramina, such as a reduction in the area and volume of the injured vertebral intervertebral foramina, as well as fatty degeneration of the thoracic back muscles, suggest an increased probability of developing intercostal neuralgia.
本研究旨在探讨胸椎骨质疏松性椎体压缩骨折（OVCF）患者肋间神经痛的相关因素，并建立一个预测模型，以评估胸椎骨折后患者发生肋间神经痛的可能性。
本回顾性研究纳入了我院收治的518例胸椎OVCF患者，将伴有和不伴有肋间神经痛的患者按1:1的比例进行匹配。记录患者的相关基本临床资料和影像学参数，连续变量采用t检验，分类变量采用卡方检验，以确定与肋间神经痛相关的因素。随后，使用单因素和多因素logistic回归模型对上述相关变量进行筛选，以获得相关因素。最后，建立并验证了骨质疏松性胸椎骨折的预测模型。
根据是否存在肋间神经痛，本研究共纳入104例患者。多因素logistic回归分析结果显示，损伤椎体椎间孔面积（P = 0.0008，回归系数估计值0.0490，95%置信区间0.0219 - 0.0798，OR = 1.0503）、损伤椎体椎间孔体积（P = 0.0001，回归系数值 - 0.0028，95%置信区间 - 0.0044至 - 0.0015，OR = 0.9972）和神经根面积（P = 0.0038，回归系数估计值 = - 0.0876，95%置信区间 - 0.1506至 - 0.0309，OR = 0.9161）是独立相关因素。脂肪变性率对发生肋间神经痛的概率有正向促进作用。预测模型的受试者工作特征曲线（ROC）下面积（AUC）为0.851，表明线性图模型具有一定程度的预测效度。
胸椎骨质疏松性骨折是一种常见的老年疾病，椎间孔形态参数的改变，如损伤椎体椎间孔面积和体积减小，以及胸背部肌肉脂肪变性，提示发生肋间神经痛的可能性增加。
