Risk Factors for the Development of Chronic Back Pain After Percutaneous Vertebroplasty Versus Conservative Treatment

• Published in: Calcified tissue international 2015-02, Vol.96 (2), p.89-96
• Main Authors: Peris, Pilar, Blasco, Jordi, Carrasco, Josep L., Martinez-Ferrer, Angels, Macho, Juan, Román, Luis San, Monegal, Ana, Guañabens, Nuria
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Back pain; Back Pain - etiology; Biochemistry; Biomedical and Life Sciences; Cell Biology; Chronic Pain - etiology; Endocrinology; Female; Fractures; Humans; Life Sciences; Lumbar Vertebrae - surgery; Male; Middle Aged; Original Research; Orthopedics; Osteoporosis; Osteoporotic Fractures - complications; Pain Measurement; Risk Factors; Spinal Fractures - complications; Spinal Fractures - surgery; Thoracic Vertebrae - surgery; Treatment Outcome; Vertebrae; Vertebroplasty - adverse effects
• ISSN: 0171-967X; 1432-0827
• DOI: 10.1007/s00223-014-9940-x

In a recent randomized controlled trial comparing vertebroplasty (VP) versus conservative treatment (CT) in patients with symptomatic vertebral fractures (VF), we observed the development of chronic back pain (CBP) in nearly one-quarter of patients. The aim of this study was to identify the risk factors related to the development of severe CBP in these subjects. We evaluated risk factors including visual analog scale (VAS) at baseline and during the 1-year follow-up, age, gender, symptom onset time, number, type and severity of VF at baseline, number of vertebral bodies treated, incident VF, and antiosteoporotic treatment, among others. CBP was considered in patients with VAS ≥ 7 at 12 months. 91/125 patients completed the 12-months follow-up. CBP was observed in 23 % of VP-treated patients versus 23 % receiving CT. Patients developing CBP after VP showed a longer symptom onset time (82 % ≥ 4 months in VP vs. 40 % in CT, P  = 0.03). On univariate analysis, female gender (OR 1.52; 95 % CI 1.47–1.57, P