Skip to main content
Top
Published in: Journal of Orthopaedic Surgery and Research 1/2024

Open Access 01-12-2024 | Back Pain | Research Article

Establishment of a risk prediction model for residual low back pain in thoracolumbar osteoporotic vertebral compression fractures after percutaneous kyphoplasty

Authors: Weiqiao Tu, Yanping Niu, Peng Su, Di Liu, Fanguo Lin, Yongming Sun

Published in: Journal of Orthopaedic Surgery and Research | Issue 1/2024

Login to get access

Abstract

Objective

This study aims to identify potential independent risk factors for residual low back pain (LBP) in patients with thoracolumbar osteoporotic vertebral compression fractures (OVCFs) following percutaneous kyphoplasty (PKP) treatment. Additionally, we aim to develop a nomogram that can accurately predict the occurrence of residual LBP.

Methods

We conducted a retrospective review of the medical records of thoracolumbar OVCFs patients who underwent PKP treatment at our hospital between July 2021 and December 2022. Residual LBP was defined as the presence of moderate or greater pain (VAS score ≥ 4) in the low back one day after surgery, and patients were divided into two groups: the LBP group and the non-LBP group. These patients were then randomly allocated to either a training or a validation set in the ratio of 7:3. To identify potential risk factors for residual LBP, we employed lasso regression for multivariate analysis, and from this, we constructed a nomogram. Subsequently, the predictive accuracy and practical clinical application of the nomogram were evaluated through a receiver operating characteristic (ROC) curve, a calibration curve, and a decision curve analysis (DCA).

Results

Our predictive model revealed that five variables—posterior fascial oedema, intravertebral vacuum cleft, time from fracture to surgery, sarcopenia, and interspinous ligament degeneration—were correlated with the presence of residual LBP. In the training set, the area under the ROC was 0.844 (95% CI 0.772–0.917), and in the validation set, it was 0.842 (95% CI 0.744–0.940), indicating that the model demonstrated strong discriminative performance. Furthermore, the predictions closely matched actual observations in both the training and validation sets. The decision curve analysis (DCA) curve suggested that the model provides a substantial net clinical benefit.

Conclusions

We have created a novel numerical model capable of accurately predicting the potential risk factors associated with the occurrence of residual LBP following PKP in thoracolumbar OVCFs patients. This model serves as a valuable tool for guiding specific clinical decisions for patients with OVCFs.
Literature
4.
go back to reference Vendeuvre T, Brossard P, Pic JB, et al. Vertebral balloon kyphoplasty versus vertebral body stenting in non-osteoporotic vertebral compression fractures at the thoracolumbar junction: a comparative radiological study and finite element analysis (BONEXP study). Eur Spine J Off Publ Eur Spine Soc Eur Spinal Deform Soc Eur Sect Cerv Spine Res Soc. 2021;30(10):3089–98. https://doi.org/10.1007/s00586-021-06785-5.CrossRef Vendeuvre T, Brossard P, Pic JB, et al. Vertebral balloon kyphoplasty versus vertebral body stenting in non-osteoporotic vertebral compression fractures at the thoracolumbar junction: a comparative radiological study and finite element analysis (BONEXP study). Eur Spine J Off Publ Eur Spine Soc Eur Spinal Deform Soc Eur Sect Cerv Spine Res Soc. 2021;30(10):3089–98. https://​doi.​org/​10.​1007/​s00586-021-06785-5.CrossRef
5.
go back to reference Ning L, Zhu J, Tian S, et al. Correlation analysis between basic diseases and subsequent vertebral fractures after percutaneous kyphoplasty (PKP) for osteoporotic vertebral compression fractures. Pain Physician. 2021;24(6):E803–10.CrossRefPubMed Ning L, Zhu J, Tian S, et al. Correlation analysis between basic diseases and subsequent vertebral fractures after percutaneous kyphoplasty (PKP) for osteoporotic vertebral compression fractures. Pain Physician. 2021;24(6):E803–10.CrossRefPubMed
8.
15.
go back to reference Teng MMH, Wei CJ, Wei LC, et al. Kyphosis correction and height restoration effects of percutaneous vertebroplasty. AJNR Am J Neuroradiol. 2003;24(9):1893–900.PubMedPubMedCentral Teng MMH, Wei CJ, Wei LC, et al. Kyphosis correction and height restoration effects of percutaneous vertebroplasty. AJNR Am J Neuroradiol. 2003;24(9):1893–900.PubMedPubMedCentral
28.
go back to reference Jones KI, Doleman B, Scott S, Lund JN, Williams JP. Simple psoas cross-sectional area measurement is a quick and easy method to assess sarcopenia and predicts major surgical complications. Colorectal Dis Off J Assoc Coloproctol G B Irel. 2015;17(1):O20-26. https://doi.org/10.1111/codi.12805.CrossRef Jones KI, Doleman B, Scott S, Lund JN, Williams JP. Simple psoas cross-sectional area measurement is a quick and easy method to assess sarcopenia and predicts major surgical complications. Colorectal Dis Off J Assoc Coloproctol G B Irel. 2015;17(1):O20-26. https://​doi.​org/​10.​1111/​codi.​12805.CrossRef
33.
40.
go back to reference Keorochana G, Taghavi CE, Tzeng ST, et al. MRI classification of interspinous ligament degeneration of the lumbar spine: intraobserver and interobserver reliability and the frequency of disagreement. Eur Spine J Off Publ Eur Spine Soc Eur Spinal Deform Soc Eur Sect Cerv Spine Res Soc. 2010;19(10):1740–5. https://doi.org/10.1007/s00586-010-1327-8.CrossRef Keorochana G, Taghavi CE, Tzeng ST, et al. MRI classification of interspinous ligament degeneration of the lumbar spine: intraobserver and interobserver reliability and the frequency of disagreement. Eur Spine J Off Publ Eur Spine Soc Eur Spinal Deform Soc Eur Sect Cerv Spine Res Soc. 2010;19(10):1740–5. https://​doi.​org/​10.​1007/​s00586-010-1327-8.CrossRef
Metadata
Title
Establishment of a risk prediction model for residual low back pain in thoracolumbar osteoporotic vertebral compression fractures after percutaneous kyphoplasty
Authors
Weiqiao Tu
Yanping Niu
Peng Su
Di Liu
Fanguo Lin
Yongming Sun
Publication date
01-12-2024
Publisher
BioMed Central
Published in
Journal of Orthopaedic Surgery and Research / Issue 1/2024
Electronic ISSN: 1749-799X
DOI
https://doi.org/10.1186/s13018-024-04528-y

Other articles of this Issue 1/2024

Journal of Orthopaedic Surgery and Research 1/2024 Go to the issue