Han Weiqi, Deng Zhibo, Lin Zhao, Luo Jun, Xu Jie
Shengli Clinical Medical College of Fujian Medical University, Fuzhou, People's Republic of China.
Department of Orthopaedics, Shaoxing People's Hospital, Shaoxing, Zhejiang, People's Republic of China.
Sci Rep. 2025 May 14;15(1):16791. doi: 10.1038/s41598-025-01839-w.
The objective of this study was to introduce and validate a novel developed scoring system tailored specifically for osteoporotic vertebral compression fractures (OVCFs), aiming to provide guidance for treatment selection. A retrospective analysis spanning from March 2016 to March 2021 was conducted on 208 patients diagnosed with osteoporotic vertebral compression fractures (OVCFs) who received conservative treatment. Patients were categorized into low-score (47 cases), medium-score (98 cases), and high-score (63 cases) groups based on the Novel Assessment System for OVCFs (NASOVCF) scores. Comparative analyses of radiographic and clinical data were performed, and logistic regression analysis was used to determine the risk factors for bone non-union and progressive kyphosis. The high-score group exhibited significantly inferior outcomes, characterized by higher Visual Analog Scale (VAS) and Oswestry Disability Index (ODI) scores (P < 0.05), increased vertebral height loss, and kyphosis angle differences compared to the low and medium-score groups (P < 0.05). Notably, a bone union rate of 38.1% (24/63) was observed in the high-score group, significantly lower than that of the low-score group (97.9%, 46/47). Furthermore, the progressive kyphosis rate was 47.6% (30/63) in the high-score group, significantly higher than the 17.3% (17/98) observed in the medium-score group and the 2.2% (1/46) observed in the low-score group. In multivariate analysis, higher NASOVCF score emerged as an independent risk factor for bone non-union (OR = 1.713, 95% CI 1.458-2.013, P < 0.001). Similarly, higher NASOVCF score (OR = 1.373, 95% CI 1.203-1.568, P < 0.001), along with female gender and higher pre-treatment ODI score, were identified as independent risk factors for progressive kyphosis. The area under the curve (AUC) for bone non-union and progressive kyphosis were 0.895 and 0.835, respectively, indicating robust discriminative performances. Higher NASOVCF score was identified as a significant risk factor for non-union and progressive kyphosis following conservative treatment in OVCFs. NASOVCF score emerged as a crucial predictor for adverse outcomes in patients at high risk who underwent conservative management. Surgical interventions such as vertebral augmentation may represent a potentially superior option for individuals with high NASOVCF scores.
本研究的目的是引入并验证一种专门为骨质疏松性椎体压缩骨折（OVCF）开发的新型评分系统，旨在为治疗选择提供指导。对208例诊断为骨质疏松性椎体压缩骨折并接受保守治疗的患者进行了一项回顾性分析，时间跨度为2016年3月至2021年3月。根据新型骨质疏松性椎体压缩骨折评估系统（NASOVCF）评分，将患者分为低分（47例）、中分（98例）和高分（63例）组。对影像学和临床数据进行了比较分析，并采用逻辑回归分析确定骨不愈合和进行性后凸的危险因素。与低分和中分组合相比，高分组的结果明显较差，表现为视觉模拟量表（VAS）和Oswestry功能障碍指数（ODI）评分更高（P<0.05），椎体高度丢失增加，以及后凸角差异（P<0.05）。值得注意的是，高分组的骨愈合率为38.1%（24/63），明显低于低分（97.9%，46/47）。此外，高分组的进行性后凸率为47.6%（30/63），明显高于中分（17.3%，17/98）和低分（2.2%，1/46）。在多变量分析中，较高的NASOVCF评分是骨不愈合的独立危险因素（OR=1.713，95%CI 1.458-2.013，P<0.001）。同样，较高的NASOVCF评分（OR=1.373，95%CI 1.203-1.568，P<0.001），以及女性性别和较高的治疗前ODI评分，被确定为进行性后凸的独立危险因素。骨不愈合和进行性后凸的曲线下面积（AUC）分别为0.895和0.835，表明具有较强的鉴别性能。较高的NASOVCF评分被确定为OVCF保守治疗后骨不愈合和进行性后凸的重要危险因素。NASOVCF评分成为接受保守治疗的高危患者不良结局的关键预测指标。对于NASOVCF评分高的个体，椎体强化等手术干预可能是一种潜在的更好选择。
