Analysis Of Risk Factors For Residual Pain In The Low Back After Vertebroplasty For Osteoporotic Vertebral Compression Fractures

Objective:To investigate the risk factors for residual pain after Vertebroplasty for osteoporotic vertebral compression fractures(OVCFs).Methods:A retrospective analysis was conducted on 127 OVCFs patients,19 males and 108 females,aged 58-88 years,who underwent vertebroplasty treatment in the Orthopedic Spinal Disease Department of Shanxi Provincial People’s Hospital from June 2020 to December 2022.Residual postoperative pain was defined as moderate or above pain in the fractured vertebral body and its vicinity after 1 day of ambulation(VAS score ≥ 4points).According to the definition,patients were divided into a pain group of 22 cases and a control group of 105 cases.The age,gender,BMI,diabetes prevalence,preoperative bone mineral density T value,fracture segment,soft tissue injury in the back of the waist,surgical method(PVP or PKP),bone cement injection amount,vertebral height recovery,bone cement leakage,and bone cement distribution of the two groups of patients were recorded,and the above factors were analyzed by single factor analysis,Logistic regression analysis was used to determine the independent risk factors for residual pain after vertebral augmentation surgery using statistically significant factors.Results:The univariate analysis showed no statistical difference between the pain group and the control group in terms of gender,age,BMI,fracture segment,and cement leakage(P>0.05),and there were differences in diabetes mellitus,BMD T value,soft tissue injury in the low back,cement injection,cement distribution,and vertebral body height recovery(P<0.05);multi-factor Logistic regression analysis of low back soft tissue injury(P=0.220),and having diabetes(P=0.490),were not independent risk factors;bone density(P=0.004),and vertebral height recovery(P=0.028)were protective factors(β<0);bone cement injection(P=0.049),and poor bone cement distribution(P=0.006)were risk factors(β>0).Conclusion:Low bone density,poor vertebral height recovery,excessive cement injection,and poor cement distribution are independent risk factors for residual low back pain after vertebral body strengthening in patients with OVCFs.