Back pain from painful osteoporotic vertebral fractures: discrepancy between the actual fracture location and the location suggested by patient-reported pain or physical examination findings

Jin, Huidong; Ma, Xiaoyuan; Liu, Y; Liu, M; Yin, Xingtian; Fan, Wenjie; Zhao, Jianhua; Chen, Hangang; Su, Nan; Yang, Jae Hyuk; Liu, P

doi:10.1007/s00198-020-05434-9

Cited by 7 publications

(14 citation statements)

References 32 publications

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“…gradually forming a cognitive bias. In our prior study about back pain from OVFs, the patient-reported back pain location did not match the VF level, and the location from physical examination ndings was not colocalized with the VF segment [13]. This study also showed that the incident RP, SPT, or ASPP was not clinically correlated with clinical parameters, and a false correlation existed between the clinical parameters and timing for seeking medical aid.…”

Section: Resultsmentioning

confidence: 56%

“…This was a secondary data analysis based on information from the clinical records of 358 patients with OVFs from a prospective clinical study (November 1, 2016, to July 30, 2018) [13], which was conducted at the Spine Clinic of Daping Hospital (Third A liated Hospital) of Army Medical University.…”

Section: Study Design Settingmentioning

confidence: 99%

“…In the outpatient setting, back pain is among the prevalent complaints for patients with OVFs, such pain may result from one single factor (structural factor) or several originators [10,11], even be in common with other pain-related clinical features, such as radiating pain (RP) and referred pain, among others [11][12][13]. An extensive review of literature showed that the quoted clinical features were proposed based on clinical impression rather than proper clinical study.…”

Section: Introductionmentioning

confidence: 99%

“…Our prior study demonstrated that the Back Pain-Inducing Test (BPIT) is a sensitive approach to screen patients with painful OVFs [12], indicating that back pain from OVFs is speci c. The discrepancy between the actual location of the OVF and the location suggested by RP, spinal palpation tenderness (SPT), or axial spinal percussion pain (ASPP) has been con rmed [13]. Our previous study also hinted that RP, SPT, and ASPP were not present in all patients, but approaches to characterize these incident measures in patients are underinvestigated.…”

Section: Introductionmentioning

confidence: 99%

“…We hypothesized that the incident RP, SPT, and ASPP were opportunistic events. A secondary data analysis based on the 358 patients with OVFs from a prospective clinical study [13] was performed to outline speci c clinical back pain pro les from OVFs and characterize the incident RP, SPT, and ASPP, so that comprehensive recognition regarding OVFs could be established and cognitive biases could be avoided for medical students, family doctors, general practitioners, residents, chiropractors, physiotherapists, and paramedics.…”

Section: Introductionmentioning

confidence: 99%

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Clinical Profiles of Osteoporotic Vertebral Compression Fractures: A Secondary Data Analysis of 358 Patients from a Prospective Clinical Study

Jin¹,

Ma²,

Liu³

et al. 2020

Preprint

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Background: For back pain patients with spine dysfunction, clinical profiles are crucial for clinicians to establish the diagnostic and therapeutic decision-making. The objectives of this study were (1) to outline the incident clinical findings and familiarize physicians with the clinical profiles of osteoporotic vertebral fractures (OVFs) and (2) to characterize patients with radiating pain (RP), spinal palpation tenderness (SPT), or axial spinal percussion pain (ASPP). Methods: This is a secondary data analysis of 358 patients from a prospective clinical study (November 1, 2016, to September 30, 2018) with particular focus on the incident RP, SPT, and ASPP. Predictive analyses for the incident RP, SPT and ASPP were done along the clinical profiles in 358 patients (284 females).Results: The cohort patients who complained of spinal movement-related pain performed a limited amplitude of movements with the purpose of avoiding the onset of back pain in daily life. Of the patients who had OVFs, 76 (21.2%) patients had RP, 197 (55.0%) patients had SPT, and 83 (23.2%) patients had ASPP. On multiple regression analysis, only patients with VFs located in T1–T9 or those who had a -2.5 ≤ T-score < -3.5 showed significantly higher incidences of RP, SPT, and ASPP (p < 0.05).Conclusion: Dynamic back pain and backache avoidance behavior are the typical clinical presentations of patients with OVFs. RP, SPT, and ASPP are nondeterministic incidents, indicating that avoidance is necessary with respect to cognitive bias in clinical practice.

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Section: Resultsmentioning

confidence: 56%

Section: Study Design Settingmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Clinical Profiles of Osteoporotic Vertebral Compression Fractures: A Secondary Data Analysis of 358 Patients from a Prospective Clinical Study

Jin¹,

Ma²,

Liu³

et al. 2020

Preprint

View full text Add to dashboard Cite

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Clinical relevance of diagnosis and treatment of vertebral fractures

Turk,

Gerards,

Lems

2024

Reference Module in Biomedical Sciences

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Pain Location Is Associated with Fracture Type in Acute Osteoporotic Thoracolumbar Vertebral Fracture: A Prospective Observational Study

et al. 2021

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Objective This study investigated the relationship between pain location and fracture type in the patients with acute osteoporotic vertebral fracture (OVF). Design A prospective observation study. Subject A total of 306 patients with acute OVF were included. Methods The site of pain of each patient was recorded, and the patients were divided into pain at fracture site group (group 1) and pain at non-fracture site group (group 2). The fracture type was classified into four types: type I, upper endplate type; type II, central type; type III, lower endplate type; type IV, burst type. Results There were 146 patients in the group 1, of which 20.55% (30/146) were type I, 33.56% (49/146) were type II, 15.75% (23/146) were type III, and 30.14% (44/146) were type IV. There were 227 patients in the group 2, of which 57.27% (130/227) were type I, 5.29% (12/227) were type II, 35.24% (80/227) were type III, and 2.20% (5/227) were type IV. There was a statistical difference in the fracture type distribution between the two groups (P < 0.05). The VAS in the group 1 was higher than that in the group 2 at the initial diagnosis (P < 0.05). Conclusions For patients with acute OVF, the site of pain is related to the type of fracture. The pain at the fracture site is more often observed in the central type and burst type of fractures, while pain at the non-fracture site is more often observed in the upper and lower endplate type of fractures. Additionally, when OVF are suspected, radiological assessment of thoracic and lumbar spine is recommended to better detect fractures that could cause pain distal to the site of the fracture.

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Back pain from painful osteoporotic vertebral fractures: discrepancy between the actual fracture location and the location suggested by patient-reported pain or physical examination findings

Cited by 7 publications

References 32 publications

Clinical Profiles of Osteoporotic Vertebral Compression Fractures: A Secondary Data Analysis of 358 Patients from a Prospective Clinical Study

Clinical Profiles of Osteoporotic Vertebral Compression Fractures: A Secondary Data Analysis of 358 Patients from a Prospective Clinical Study

Clinical relevance of diagnosis and treatment of vertebral fractures

Pain Location Is Associated with Fracture Type in Acute Osteoporotic Thoracolumbar Vertebral Fracture: A Prospective Observational Study

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