Causes of Residual Back Pain at Early Stage After Percutaneous Vertebroplasty: A Retrospective Analysis of 1,316 Cases

• Published in: Pain physician Vol. 22; no. 5; pp. E495 - E503
• Main Authors: Yang, Jun-Song, Liu, Ji-Jun, Chu, Lei, Li, Jing, Chen, Chu, Chen, Hao, Liu, Peng, Yan, Liang, Liu, Tuan-Jiang, Hao, Ding-Jun
• Format: Journal Article
• Language: English
• Published: United States American Society of Interventional Pain Physician 01.09.2019
• Subjects: Aged; Aged, 80 and over; Back pain; Back Pain - epidemiology; Back Pain - etiology; Back Pain - surgery; Bone Cements - therapeutic use; Cement; Contusions; Disease Progression; Female; Fractures; Fractures, Compression - surgery; Humans; Male; Middle Aged; Multivariate Analysis; Odds Ratio; Osteoporotic Fractures - surgery; Retrospective Studies; Risk Factors; Spinal Fractures - surgery; Vertebroplasty - adverse effects
• ISSN: 1533-3159; 2150-1149

Percutaneous vertebroplasty (PVP) is now well accepted in the treatment of painful osteopathic vertebral compression fractures (OVCF), providing early pain relief and strengthening of the bone of the vertebrae. However, some patients still experienced severe back pain after PVP. To analyze the possible reason for unsatisfactory back pain relief (UBPR) after PVP at early stage. Retrospective analysis. Hong-Hui Hospital in Xi'an. Between March 2013 and January 2015, a total of 1,316 patients with OVCF were treated by PVP at our Hospital. Demographics, clinical data, and surgical data were collected to analyze the factors associated with UBPR after PVP. Sixty cases complained of UBPR, and the prevalence was 4.6%. Univariate analyses showed that preoperative bone mineral density (BMD), number of fractures, cement distribution and volume injected per level, lumbodorsal fascia contusion, and depression were associated with UBPR after PVP (P < 0.001). Multivariate analysis revealed that preoperative BMD (odds ratio [OR], 3.577; P = 0.029), lumbodorsal fascia contusion (OR, 3.805; P = 0.002), number of fractures (OR, 3.440; P < 0.001), cement volume injected per level (OR, 0.079; P < 0.001), cement distribution (OR, 3.009; P = 0.013), and depression (OR, 3.426; P = 0.028) were independently associated with UBPR after PVP at the early postoperative stage. A further prospective controlled study is needed to explore the association between the different degrees of the aforementioned factors and UBPR after PVP. Preoperative low BMD, lumbodorsal fascial injury, multiple segment PVP, insufficient cement injected volume, unsatisfactory cement distribution, and depression were strong risk factors associated with UBPR after PVP in patients with OVCF. Unsatisfactory back pain relief, residual back pain, percutaneous vertebroplasty.