Risk factors for postoperative residual back pain after percutaneous kyphoplasty for osteoporotic vertebral compression fractures
Risk factors for postoperative residual back pain after percutaneous kyphoplasty for osteoporotic vertebral compression fractures
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DOI：
10.1007/s00586-020-06493-6
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发表时间：
2020-06-07
影响因子：
2.8
通讯作者：
Wang, Xiangyang
中科院分区：
文献类型：
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作者：
Li, Yao;Yue, Jinxin;Wang, Xiangyang
目的回顾分析经皮椎体后凸成形术(PKP)治疗骨质疏松性椎体压缩骨折(OVCF)后残余腰痛的发生率及其危险因素。方法对符合本研究纳入标准的接受双侧PKP的患者进行回顾性分析。术后使用视觉模拟评分(VAS)评估背部疼痛强度。残余背痛被定义为术后存在中-重度疼痛(平均VAS评分=4)，变量包括患者特征、基线症状、放射学参数和手术因素。采用单因素和多因素Logistic回归分析确定危险因素。结果共纳入809例患者，其中63例(7.8%)存在残余背痛。在这些患者中，52名患者有完整的数据供进一步分析。多因素Logistic回归分析显示，腰背痛的危险因素有椎体内真空裂隙(OR2.93，P=0.032)、后筋膜水肿(OR4.11，P=0.014)、关节突关节破坏(OR12.19，P<；0.001)和骨水泥分布分离(OR2.23，P=0.043)。结论809例经皮冠状动脉腔内成形术患者术后残余腰背痛发生率为7.8%。椎体内真空裂隙、后筋膜水肿、关节突关节破坏和分离的骨水泥分布被确定为残余背痛的独立危险因素。
Purpose To determine the incidence of and risk factors for residual back pain in osteoporotic vertebral compression fracture (OVCF) patients after percutaneous kyphoplasty (PKP) treatment, we performed a retrospective analysis of prospective data. Methods Patients who underwent bilateral PKP and met this study's inclusion criteria were retrospectively reviewed. Back pain intensity was assessed using a visual analogue scale (VAS) after surgery. 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, radiological parameters and surgical factors. Univariate and multivariate logistic regression analyses were performed to identify risk factors. Results A total of 809 patients were included, and residual back pain was identified in 63 (7.8%) patients. Of these patients, 52 patients had complete data for further analysis. Multivariate logistic regression analysis showed that risk factors for back pain included the presence of an intravertebral vacuum cleft (OR 2.93, P = 0.032), posterior fascia oedema (OR 4.11, P = 0.014), facet joint violations (OR 12.19, P < 0.001) and a separated cement distribution (OR 2.23, P = 0.043). Conclusion The incidence of postoperative residual back pain was 7.8% among 809 OVCF patients following PKP. The presence of an intravertebral vacuum cleft, posterior fascia oedema, facet joint violations and a separated cement distribution were identified as independent risk factors for residual back pain.