Analysis of postoperative pain risk and its influencing factors in patients with thoracolumbar fracture undergoing percutaneous vertebroplasty
10.3760/cma.j.cn115396-20240605-00173
- VernacularTitle:胸腰椎骨折经皮椎体成形术患者术后疼痛风险及其影响因素分析
- Author:
Juan WANG
1
;
Yuming LI
;
Fan XIA
Author Information
1. 南京市中心医院骨科，南京 210000
- Keywords:
Fractures, bone;
Pain;
Risk;
Risk factors;
Bone density
- From:
International Journal of Surgery
2024;51(11):741-746
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the pain risk of patients with thoracolumbar fractures after percutaneous vertebroplasty(PVP) and analyze its influencing factors.Methods:The clinical data of 120 patients with osteoporotic vertebral compression fracture (OVCF) treated by PVP in Nanjing Central Hospital from March 2019 to March 2024 were analyzed by retrospective case-control study, including 58 males and 62 females. The age ranged from 56 to 86 years, with an average age of (71.06±6.78) years. According to whether there was short-term recurrent pain (SRP) at the primary site after operation, they were divided into SRP group ( n=32) and non-SRP group ( n=88). The gender, age, anesthesia mode and operation time of OVCF patients between the two groups were compared.The measurement data were expressed as mean±standard deviation ( ± s), and t-test was used for comparison between groups; Counting data were expressed as cases and percentage, and Chi-square test was used for comparison between groups. Multivariate Logistic regression method was used to analyze the risk factors of postoperative SRP and put them into nomogram model. Receiver operating characteristic (ROC) curve and calibration curve were selected to analyze and verify the accuracy of prediction. Results:After PVP in 120 patients with OVCF, 32 patients developed SRP, accounting for 26.7%. The proportion of smoking history, long-term use of analgesic drugs, the number of operated vertebral bodies (multiple segments) and the American Association of Anesthesiologists(ASA) classification (Ⅲ-Ⅳ grade) in SRP group were higher than those in non-SRP group, while the proportion of fracture segments(thoracic vertebrae) and bone mineral density were lower than those in non-SRP group, the differences were statistically significant ( P<0.05). Multivariate Logistic regression analysis showed that smoking history ( OR=8.146), bone mineral density ( OR=0.001) and the number of vertebral bodies ( OR=10.595) were independent risk factors for SRP after PVP in OVCF patients ( P<0.05). Conclusions:The risk of SRP after PVP in OVCF patients is high, which needs to be improved. Smoking history, bone mineral density and the number of vertebral bodies after operation are independent risk factors of SRP in OVCF patients after PVP.
