Lu Wei, Teng Zhaowei, Chen Jiayu, Shi Rongmao, Zou Tiannan, Gao Ming, Li Weichao, Peng Zhi, Wang Long, Zhao Yonghui, Lu Sheng
Yunnan Key Laboratory of Digital Orthopedics, the First People's Hospital of Yunnan Province, Kunming, People's Republic of China.
Department of Orthopedics, the First People's Hospital of Yunnan Province, Kunming, People's Republic of China.
J Pain Res. 2023 Mar 17;16:961-971. doi: 10.2147/JPR.S375966. eCollection 2023.
The objective of this study was to analyze the clinical characteristics and the therapeutic effects of treatment at our spinal center in OVCF patients associated with referred pain. The underlying goals were to deepen the understanding of referred pain caused by OVCFs, improve the currently low early diagnosis rate of OVCFs, and improve the effectiveness of treatment.
The patients who had referred pain from OVCFs and met the inclusion criteria were retrospectively analyzed. All patients were treated with percutaneous kyphoplasty (PKP). Visual analog scale (VAS) scores and Oswestry Disability Index (ODI) were used to evaluate the therapeutic effect at different time points.
There were 11 males (19.6%) and 45 females (80.4%). Their corresponding mean bone mineral density (BMD) value was -3.3 ± 0.4. The regression coefficient of BMD in the linear regression equation was -4.51 (P<0.001). According to the classification system for referred pain in OVCFs, there were 27 cases of type A (48.2%), 12 cases of type B (21.2%), 8 cases of type C (14.3%), 3 cases of type D (5.4%), and 6 cases of type E (10.7%). All patients were followed up for at least 6 months, and both VAS scores and ODI were found to be significantly better postoperatively than preoperatively (P<0.001). There was no significant difference in VAS scores and ODI between different types preoperatively or 6 months postoperatively (P > 0.05). Within each type, there were significant differences in VAS scores and ODI between the pre- and postoperative timepoints (P < 0.05).
Attention should be paid to referred pain in OVCF patients, which is not uncommon in clinical practice. Our summary of the characteristics of referred pain caused by OVCFs can improve the early diagnosis rate of OVCFs patients and provide a reference for their prognosis after PKP.
本研究的目的是分析在我们脊柱中心接受治疗的伴有牵涉痛的骨质疏松性椎体压缩骨折(OVCF)患者的临床特征和治疗效果。潜在目标是加深对OVCFs所致牵涉痛的理解,提高目前较低的OVCFs早期诊断率,并提高治疗效果。
对有OVCFs牵涉痛且符合纳入标准的患者进行回顾性分析。所有患者均接受经皮椎体后凸成形术(PKP)治疗。采用视觉模拟评分法(VAS)和Oswestry功能障碍指数(ODI)在不同时间点评估治疗效果。
男性11例(19.6%),女性45例(80.4%)。他们相应的平均骨密度(BMD)值为-3.3±0.4。线性回归方程中BMD的回归系数为-4.51(P<0.001)。根据OVCFs牵涉痛的分类系统,A型27例(48.2%),B型12例(21.2%),C型8例(14.3%),D型3例(5.4%),E型6例(10.7%)。所有患者均随访至少6个月,发现术后VAS评分和ODI均显著优于术前(P<0.001)。术前不同类型之间以及术后6个月时VAS评分和ODI均无显著差异(P>0.05)。在每种类型内,术前和术后时间点的VAS评分和ODI均有显著差异(P<0.05)。
应关注OVCF患者的牵涉痛,这在临床实践中并不少见。我们对OVCFs所致牵涉痛特征的总结可以提高OVCFs患者的早期诊断率,并为PKP术后的预后提供参考。