| Objective:Osteoporotic Vertebral compression fracture(OVCF): Osteoporosis(OP)is the most common type of osteoporotic fracture caused by the reduction of bone quality,degeneration of bone microstructure,and increase of bone brittleness,which occurs in the absence of obvious trauma or even in daily activities.Vertebral fractures mostly occur in the thoracolumbar segment.The most common clinical symptom of OVCF patients is pain.Due to the hidden pathogenic factors of patients and the diversity of clinical pain symptoms,some doctors and patients fail to take vertebral factors into account,resulting in a low early diagnosis rate and easy to cause chronic back pain and other complications,resulting in increased burden on patients’ families and society.Therefore,this study intends to observe the clinical characteristics of the group with distant pain in patients with thoracolumbar OVCF and make statistical comparison with the clinical data of the group with local pain in the fractured vertebral body,and explore the related influencing factors that may cause distant pain in patients with thoracolumbar OVCF.To improve the understanding of distant pain in patients with THORAColumbar OVCF,and provide possible new ideas and data support for future research on distant pain in patients with OVCF.Methods:A retrospective study was used to select OVCF patients admitted to the Affiliated Hospital of Yan’an University from October 2019 to January 2022.According to the inclusion and exclusion criteria,a total of 166 patients with primary thoracolumbar OVCF were selected for investigation and research.The basic clinical information of patients collected in this study mainly includes: age,gender,hypertension,diabetes,body mass index(BMI),bone mineral density(BMD),visual analog score(Visual analogue scale,VAS)score and functional disability index score(Oswestry dability index,ODI).Through the medical cloud imaging system of the Radiology Department of Yan’an University Affiliated Hospital,the degree of compression change of the fractured vertebral body,the change rate of the anterior edge height of the fractured vertebral body,the sagittal Cobb angle of the fractured vertebral body,the wedge deformation angle of the fractured vertebral body,and the fractured vertebral body were collected.The rate of change in the height,width,and area of the intervertebral foramen in the body.The 166 patients included were divided into two types according to the different pain sites: Type A: pain only in the fractured vertebral body,and no subjective pain at the fractured vertebral body;Type B: containing the fractured vertebral body distally Pain group.By comparing the relevant clinical data between the fractured vertebral body pain group and the fractured vertebral body pain group,the clinical characteristics and independent influencing factors of distant pain in thoracolumbar OVCF patients were described and analyzed.Results:1.Demographic and clinical distribution characteristics of thoracolumbar OVCF patients with distant pain groups: Among the 73 thoracolumbar OVCF patients,more than half were women(47;64.4%)and men(26;35.6%));age range distribution: 27 patients aged 55-70 years,32 patients aged 70-85 years,and 14 patients aged 85 and above,with an average age of 71.90±8.25 years old;clinical distribution characteristics of patients with pain in distant parts There were 42 patients(57.5%)with lumbosacral and buttock pain,followed by 15 patients(20.5%)with iliac crest and lower abdominal pain,12 patients(16.4%)with intercostal pain and 4 patients(5.6%)with other pain.2.Comparison between groups of general clinical data: According to the comparison between the fractured vertebral body pain group and the fractured vertebral body pain group with distant part of the body,there are statistical differences in bone mineral density(BMD)and visual analogue scale(VAS)between the groups.There was no significant difference(P<0.05)with age,gender,hypertension,diabetes and functional disability index(ODI)between the groups(P>0.05).3.Comparison of anatomic parameters of fractured vertebral bodies between groups: According to the comparison between the local pain group and the distant pain group,there were statistically significant differences in the change degree of vertebral compression height,the sagittal Cobb Angle of vertebral body,the change rate of anterior vertebral height,the wedge Angle of fractured vertebral body and the change rate of upper intervertebral foramina area between the groups(P<0.05).There was no significant difference in the change rate of height and width of upper foramina between groups(P>0.05).4.Risk factor analysis: VAS score,bone mineral density(BMD),the rate of change in the height of the anterior edge of the fractured vertebral body,the sagittal Cobb angle of the vertebral body,the wedge angle of the fractured vertebral body,and the area of the intervertebral foramen on the fractured vertebral body.The rate of change was analyzed by binary logistic regression.The results showed that the degree of compression of the fractured vertebral body,the sagittal Cobb angle of the fractured vertebral body and the wedge angle of the fractured vertebral body were the independent influencing factors of pain in the distal part of the thoracolumbar fractured vertebral body.Conclusion:1.The most common sites for distal pain in patients with thoracolumbar OVCF are the lumbosacral region and buttocks,which are more common in middle-aged and elderly women.2.The degree of change in the height of the fractured vertebral body,the sagittal Cobb angle of the vertebral body and the wedge angle of the vertebral body are the independent risk factors of pain in the distal part of the patients with thoracolumbar OVCF.3.The pain localization of patients with OVCF in the thoracolumbar segment is not completely the site of actual vertebral compression fracture.Regardless of whether the vertebral body has been injured or not,the vertebral body should be examined after excluding pain caused by other common diseases in middle-aged and elderly patients,so as to improve the treatment level and therapeutic effect for OVCF patients. |
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