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

Abstract

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.

A novel scoring system to predict the residual back pain after percutaneous kyphoplasty for osteoporotic vertebral compression fracture

“…Secondly, we also found that OVCF patients with kyphosis had higher postoperative VAS scores and less pain relief. We speculate that this may be related to the severity of vertebral fracture ( 20 ), namely, burst fracture (or vertebral posterior margin fracture) and combined kyphosis suggested severe injury violence and vertebral fracture. In addition, we found that patients with thoracolumbar vertebral fracture had more obvious pain relief after PKP, while patients with thoracic or lumbar vertebral fracture had higher postoperative VAS scores, which may be related to higher anatomical stability of thoracic vertebral segments ( 21 ).…”

Effects of aquatic therapy on people with osteopenia or osteoporosis: A systematic review

“…OP is considered a silent disease, but pain is still one of the first complaints of those patients. Usually, OP patients experience two types of pain: acute pain, usually related to fractures (Zhang et al., 2021) (when, usually, the disease is diagnosed) and chronic pain, usually low back pain. In this case, pain includes peripheral characteristics–such as postural alterations, fractures and associated muscle atrophy (Catalano et al., 2017) – but also has influence of the psychosocial context, which can make the pain experience even worse (Raja et al., 2020).…”

“…It is known that people with osteoporosis and osteopenia exhibit a functional decline in balance (Aveiro et al., 2017) and mobility (Murtezani et al., 2014), which are both variables that increase the risk of falling (Zhang et al., 2021). Therefore, it is crucial that the treatment protocol aims to improve these functions in order to prevent falling and the resulting fractures (Trevisan et al., 2015).…”

Unilateral Percutaneous Kyphoplasty Using a Novel Guide Device for Thoracolumbar Osteoporotic Vertebral Fracture

“…[1][2][3][4] Thoracolumbar osteoporotic vertebral fractures (TLOVFs) are the most common complication of osteoporosis and can not only affect patients' work and daily life but also lead to other functional disorders, spinal deformities, and sometimes even paralysis. [5][6][7][8] Percutaneous kyphoplasty (PKP) is a rapid, effective, and minimally invasive technique for treating TLOVFs in elderly patients, and it can speed recovery of function and improve quality of life with fewer complications compared with conservative treatment. [9][10][11][12][13] However, surgeons are heavily dependent on image-guided navigation, especially when the surgeon is inexperienced.…”

“…Fractures of the thoracolumbar spine represent 42.4%–75.2% of all spinal fractures, followed by lumbar and cervical spine fractures 1–4 . Thoracolumbar osteoporotic vertebral fractures (TLOVFs) are the most common complication of osteoporosis and can not only affect patients' work and daily life but also lead to other functional disorders, spinal deformities, and sometimes even paralysis 5–8 …”