Characterizing the course of back pain after osteoporotic vertebral fracture: a hierarchical cluster analysis of a prospective cohort study.
Characterizing the course of back pain after osteoporotic vertebral fracture: a hierarchical cluster analysis of a prospective cohort study.
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骨质疏松性椎体骨折后背痛病程的特征：前瞻性队列研究的层次聚类分析。
DOI：
10.1007/s11657-017-0377-5
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发表时间：
2017
期刊：
影响因子：
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通讯作者：
Nakamura H.
中科院分区：
文献类型：
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作者：
Toyoda H;Takahashi S;Hoshino M;Takayama K;Iseki K;Sasaoka R;Tsujio T;Yasuda H;Sasaki T;Kanematsu F;Kono H;Nakamura H.
摘要本研究证实了四种不同的模式，在过程中的背痛后，骨质疏松性脊椎骨折（OVF）。更大的角度不稳定性，在第一个6个月后的基线是一个因素，影响背部疼痛后OVF.PurposeUnderstanding的自然过程中的症状急性OVF是重要的，在决定最佳的治疗策略。我们使用潜在的类分析，以分类OVF后背痛的过程中，并确定与持续性pain.MethodsThis多中心队列研究纳入了218例连续患者≤ 2周龄OVF谁在11个机构登记。在入组时以及1个月、3个月和6个月随访时获得动态X线片和背部疼痛视觉模拟量表（VAS）评估。VAS评分被用来描述患者组，使用分层聚类分析。ResultsVAS为128例患者被用于分层聚类分析。分析产生了四个聚类，代表不同的背痛进展模式。第1组患者（50.8%）有稳定的轻度疼痛。第2组患者（21.1%）开始时为中度疼痛，并迅速进展至极低疼痛。第3组患者（10.9%）有中度疼痛，最初有所改善，但3个月后恶化。第4组患者（17.2%）有持续性重度疼痛。第4组的患者表现出显著的高基线疼痛强度，更高程度的角度不稳定性，以及更高数量的既往OVF，并且倾向于缺乏定期锻炼。相比之下，在集群2的患者有显着降低基线VAS和角度stability.ConclusionsWe确定了四个不同的组OVF患者的背痛进展的不同模式。了解OVF后背痛的过程可能有助于其管理，并有助于未来的治疗试验。
AbstractSummaryThis study demonstrated four distinct patterns in the course of back pain after osteoporotic vertebral fracture (OVF). Greater angular instability in the first 6 months after the baseline was one factor affecting back pain after OVF.PurposeUnderstanding the natural course of symptomatic acute OVF is important in deciding the optimal treatment strategy. We used latent class analysis to classify the course of back pain after OVF and identify the risk factors associated with persistent pain.MethodsThis multicenter cohort study included 218 consecutive patients with ≤ 2-week-old OVFs who were enrolled at 11 institutions. Dynamic x-rays and back pain assessment with a visual analog scale (VAS) were obtained at enrollment and at 1-, 3-, and 6-month follow-ups. The VAS scores were used to characterize patient groups, using hierarchical cluster analysis.ResultsVAS for 128 patients was used for hierarchical cluster analysis. Analysis yielded four clusters representing different patterns of back pain progression. Cluster 1 patients (50.8%) had stable, mild pain. Cluster 2 patients (21.1%) started with moderate pain and progressed quickly to very low pain. Patients in cluster 3 (10.9%) had moderate pain that initially improved but worsened after 3 months. Cluster 4 patients (17.2%) had persistent severe pain. Patients in cluster 4 showed significant high baseline pain intensity, higher degree of angular instability, and higher number of previous OVFs, and tended to lack regular exercise. In contrast, patients in cluster 2 had significantly lower baseline VAS and less angular instability.ConclusionsWe identified four distinct groups of OVF patients with different patterns of back pain progression. Understanding the course of back pain after OVF may help in its management and contribute to future treatment trials.