Risk Factors Of Residual Pain In Patients With Thoracolumbar Compression Fracture After PKP

[Objective] To analyze the clinical data of patients with thoracolumbar compression fracture undergoing percutaneous kyphoplasty(PKP),and to explore the risk factors of residual pain in the lumbar and back after PVP,so as to guide the preventive intervention measures and improve the clinical effect.[Methods] 260 cases of thoracolumbar compression fracture were included in this study.According to the visual analogue score(VAS)at 1 week,4 weeks,3 months and 6months after operation,if the score is ≥ 4 at any one time,the patients are divided into two groups: residual pain group and no residual pain group.To observe and compare the baseline data,short-term complications,fracture healing,preoperative bone density,preoperative lumbar and back soft tissue injury,preoperative vertebral height compression rate,postoperative vertebral height recovery rate,improvement rate of sagittal Cobb angle,bone cement diffusion degree of the two groups.The potential risk factors of P < 0.05 in single factor analysis were included in logistic regression analysis.[Results] There were 40 patients in residual pain group and 220 patients in no residual pain group.The incidence of postoperative residual pain was 15.4%.The BMI and BMD of patients with residual pain group were significantly lower than those without residual pain group(P < 0.001),and the proportion of patients with lumbar and back soft tissue injury,previous history of lumbar pain and falling injury was significantly higher than that of patients without residual pain group(P < 0.05).There was no significant difference in age,gender distribution,injury time from operation,distribution of fracture vertebral body(P > 0.05).The incidence of short-term complications,nonunion and recurrent fracture in the residual pain group was significantly higher than that in the non residual pain group(P < 0.001),but there was no significant difference in VAS score,unilateral / bilateral puncture approach,operation time and the amount of bone cement injected(P > 0.05).There was no difference between the two groups,but the recovery rate of vertebral height,the improvement rate of Cobb angle in sagittal plane and the total diffusion coefficient of bone cement in the residual pain group were significantly lower than those in the non residual pain group(P < 0.05).Logistic regression analysis showed that BMI,BMD,soft tissue injury of back and waist,recovery rate of vertebral height,improvement rate of Cobb angle in sagittal plane,total diffusion coefficient of bone cement,short-term complications,nonunion of fracture and recurrent fracture were the main risk factors of residual pain after PKP(P < 0.05).[Conclusion] The residual back pain after PKP is a common problem that affects the clinical effect and functional recovery of patients with thoracolumbar compression fracture.Low back soft tissue injury,spinal instability,recurrent fracture,nonunion and short-term complications are the risk factors of residual pain after PKP.Clinically,it is necessary to identify high-risk patients and carry out preventive measures to help reduce the incidence of residual pain.