Volume 23 Issue 2
Feb.  2025
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ZHENG Yonghong, ZHENG Mingjun, FENG Fabo. Analysis of the progression and factors influencing postoperative acute pain in patients with thoracolumbar fracture[J]. Chinese Journal of General Practice, 2025, 23(2): 239-242. doi: 10.16766/j.cnki.issn.1674-4152.003876
Citation: ZHENG Yonghong, ZHENG Mingjun, FENG Fabo. Analysis of the progression and factors influencing postoperative acute pain in patients with thoracolumbar fracture[J]. Chinese Journal of General Practice, 2025, 23(2): 239-242. doi: 10.16766/j.cnki.issn.1674-4152.003876

Analysis of the progression and factors influencing postoperative acute pain in patients with thoracolumbar fracture

doi: 10.16766/j.cnki.issn.1674-4152.003876
Funds:

 2024KY664

  • Received Date: 2024-01-22
    Available Online: 2025-03-27
  •   Objective  This study aims to analyze the progression of postoperative acute pain in patients with thoracolumbar fracture, analyze the variability in postoperative acute pain profiles, and explore factors affecting the patterns of different acute pain progression.  Methods  From April 2020 to September 2023, a total of 180 postoperative patients with thoracolumbar fractures underwent percutaneous vertebro plasty (PVP) in Chun'an Branch of Zhejiang Provincial People's Hospital were enrolled in this study.These patients were assessed using a general information questionnaire and a visual analogue pain scale.The study analyzed the potential profiles of acute pain after thoracolumbar fracture and identified the factors affecting acute pain through multivariate ordered logistic regression.  Results  The mean score of acute pain after thoracolumbar fracture operation was (6.78±1.13) points.When the number of categories is 3, the decline in AIC, BIC, and aBIC became gradual, and the P-value of LMRT exceeded 0.001, indicating that three potential profiles are appropriate: mild pain (35.54%), moderate pain (43.98%), and severe pain (20.48%).Patients with severe pain had a significantly higher proportion of BMI≥24, more than two fractured vertebral bodies, unsatisfied bone cement distribution, concurrent osteoporosis, high vertebral body recovery, and lumbar spine fracture sites compared to those in the mild pain group and moderate pain group (P < 0.05).Multivariate logistic analysis showed that more than two fractured vertebral bodies, BMI≥24, unsatisfactory bone cement distribution, lumbar vertebrae fracture sites, and high vertebral body recovery were significant factors influencing severe pain after thoracolumbar fractures (P < 0.05).  Conclusion  The level of acute pain in patients with thoracolumbar fracture after operation is high and exhibits heterogeneity.Notably, factor such as fracture vertebral bodies>2, BMI≥24, unsatisfactory body cement distribution, lumbar vertebrae fracture sites, and vertebral body recovery are significant contributors to severe pain in patients with thoracolumbar fractures after operation.

     

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  • [1]
    赵玉峰, 彭海文. 胸腰椎骨折的分类和手术治疗[J]. 创伤外科杂志, 2023, 25(7): 487-490.

    ZHAO Y F, PENG H W. Classification and surgical treatment of thoracolumbar fractures[J]. Journal of Traumatic Surgery, 2023, 25(7): 487-490.
    [2]
    MURATORE M, ALLASIA S, VIGLIERCHIO P, et al. Surgical treatment of traumatic thoracolumbar fractures: a retrospective review of 101 cases[J]. Musculoskelet Surg, 2021, 105(1): 49-59.
    [3]
    PEPE J, BODY J J, HADJOI P, et al. Osteoporosis in premenopausal women: a clinical narrative review by the ECTS and the IOF[J]. J Clin Endocrinol Metab, 2020, 105(8): dgaa306. DOI: 10.1210/clinem/dgaa306.
    [4]
    AULENKAMP J L, MALEWICZ N M, BRAUCKHOFF J D, et al. Chronic pain following fracture-related surgery: posttraumatic rather than postsurgical origin promotes chronification-a prospective observational study with 1-year follow-up[J]. Anesth Analg, 2022, 134(5): 974-986.
    [5]
    车向东, 李茂山, 张战峰. PKP术治疗骨质疏松性胸腰椎压缩性骨折残余腰背疼痛的危险因素分析[J]. 颈腰痛杂志, 2021, 42(1): 63-65, 69.

    CHE X D, LI M S, ZHANG Z F. Analysis of risk factors of residual low back pain in osteoporotic thoracolumbar compression fracture treated by PKP[J]. The Journal of Cervicodynia and Lumbodynia, 2021, 42(1): 63-65, 69.
    [6]
    宋建申. 患者术后疼痛轨迹的决定因素[J]. 中华医学杂志, 2021, 101(14): 1001.

    SONH J S. Determinants of postoperative pain trajectory[J]. Chinese Medical Journal, 2021, 101(14): 1001.
    [7]
    张晨旭, 谢峰, 林振, 等. 基于组轨迹模型及其研究进展[J]. 中国卫生统计, 2020, 37(6): 946-949.

    ZHANG X C, XIE F, LIN Z, et al. Group trajectory model and its research progress[J]. Chinese Journal of Health Statistics, 2020, 37(6): 946-949.
    [8]
    叶玲珑, 秦磊, 谢邦昌, 等. 老年人认知功能的异质化发展轨迹及其影响因素分析[J]. 中国卫生统计, 2021, 38(2): 183-187.

    YE L L, QIN L, XIE B C, et al. The development track of heterogeneity of cognitive function of the elderly and its influencing factors[J]. Chinese Journal of Health Statistics, 2021, 38(2): 183-187.
    [9]
    吴晨曦, 高静, 廖琴, 等. 养老机构衰弱老年人躯体症状群轨迹及影响因素的纵向研究[J]. 中国全科医学, 2022, 25(25): 3122-3129.

    WU C X, GAO J, LIAO Q, et al. A longitudinal study on the track of somatic symptoms of the frail elderly in the old-age care institutions and its influencing factors[J]. Chinese General Practice, 2022, 25(25): 3122-3129.
    [10]
    SCHNAKE K J, BLATTERT T R, HAHN P, et al. Classification of osteoporotic thoracolumbar spine fractures: recommendations of the spine section of the German society for orthopaedics and trauma (DGOU)[J]. Global Spine J, 2018, 8(2 Suppl): 46S-49S.
    [11]
    严广斌. 视觉模拟评分法[J]. 中华关节外科杂志(电子版), 2014, 8(2): 273.

    YAN G B. Visual analogue scale[J]. Chinese Journal of Joint Surgery (Electronic Version), 2014, 8(2): 273.
    [12]
    张文超, 蔡楠, 罗太君, 等. 髋关节囊周围神经阻滞与髂筋膜间隙阻滞对老年股骨粗隆间骨折患者镇痛效果的对比研究[J]. 北京医学, 2024, 46(2): 123-126.

    ZHANG W C, CAI N, LUO T J, et al. Comparison of the analgesic effects of pericapsular nerve group block and fascia iliaca compartment block on intertrochanteric fractures in elderly patients[J]. Beijing Medical Journal, 2024, 46(2): 123-126.
    [13]
    ELAFROS M A, ANDERSEN H, BENNETT D L, et al. Towards prevention of diabetic peripheral neuropathy: clinical presentation, pathogenesis, and new treatments[J]. Lancet Neurol, 2022, 21(10): 922-936.
    [14]
    WYLDE V, DENNIS J, BESWICK A D, et al. Systematic review of management of chronic pain after surgery[J]. Br J Surg, 2017, 104(10): 1293-1306.
    [15]
    胡婷业, 陆玉和, 王凯, 等. 规范化疼痛管理在骨质疏松性椎体压缩骨折患者中的术前应用效果[J]. 中华全科医学, 2019, 17(9): 1596-1599. doi: 10.16766/j.cnki.issn.1674-4152.001006

    HU T Y, LU Y H, WANH K, et al. Preoperative application effect of standardized pain management in patients with osteoporotic vertebral compression fracture[J]. Chinese Journal of General Practice, 2019, 17(9): 1596-1599. doi: 10.16766/j.cnki.issn.1674-4152.001006
    [16]
    黄震, 赵春, 杨志勇, 等. 经皮椎体成形术中应用明胶海绵封堵骨水泥渗漏的疗效[J]. 中华全科医学, 2023, 21(1): 57-61. doi: 10.16766/j.cnki.issn.1674-4152.002811

    HUANG Z, ZHAO C, YANG Z Y, et al. Effect of gelatin sponge in percutaneous vertebroplasty to block the leakage of bone cement[J]. Chinese Journal of General Practice, 2023, 21(1): 57-61. doi: 10.16766/j.cnki.issn.1674-4152.002811
    [17]
    GENG Z H, ZHOU Q F, SHAN G W, et al. Short-term efficacy of the percutaneous vertebroplasty using a curved versus straight vertebroplasty needle in osteoporotic vertebral vompression fractures[J]. Orthopedics, 2021, 44(1): e131-e138.
    [18]
    郑鸣迪. 骨质疏松性椎体压缩骨折椎体成形术后残余疼痛原因分析及对策[D]. 青岛: 青岛大学, 2019.

    ZHENG M D. Causes and countermeasures of residual pain after vertebroplasty for osteoporotic vertebral compression fracture[D]. Qingdao: Qingdao University, 2019.
    [19]
    GUTIERREZ-GONZALEZ R, ORTEGA C, ROYUELA A, et al. Vertebral compression fractures managed with brace: risk factors for progression[J]. Eur Spine J, 2023, 32(11): 3885-3891.
    [20]
    ZHANG L M, CHUN C C, YANG Y, et al. Vitamin D deficiency/insufficiency is associated with risk of osteoporotic thoracolumbar junction vertebral fractures[J]. Med Sci Monit, 2019, 25: 8260-8268.
    [21]
    ALIMOHAMMADI E, BAGHERI S R, AHADI P, et al. Predictors of the failure of conservative treatment in patients with a thoracolumbar burst fracture[J]. J Orthop Surg Res, 2020, 15(1): 514. DOI: 10.1186/s13018-020-02044-3.
    [22]
    WANG F, SUN R, ZHANG S D, et al. Comparison of thoracolumbar versus non-thoracolumbar osteoporotic vertebral compression fractures in risk factors, vertebral compression degree and pre-hospital back pain[J]. J Orthop Surg Res, 2023, 18(1): 643. DOI: 10.1186/s13018-023-04140-6.
    [23]
    王晓东, 龚强, 王晓云, 等. 经皮椎体成形术治疗骨质疏松性椎体压缩性骨折术后椎体高度恢复与疼痛缓解的相关性分析[J]. 中国临床医生杂志, 2019, 47(4): 456-458.

    WANG X D, GONG Q, WANG X Y, et al. Correlation analysis of vertebral height recovery and pain relief after percutaneous vertebroplasty for osteoporotic vertebral compression fracture[J]. Chin J Clinician, 2019, 47(4): 456-458.
    [24]
    常小波, 王爱芳, 王勤业. 经皮椎体成形术治疗骨质疏松性胸腰椎压缩骨折的疗效及影响术后残余疼痛相关因素分析[J]. 中国骨与关节损伤杂志, 2023, 38(9): 957-960.

    CHANG X B, WANG A F, WANG Q Y. Effect of percutaneous vertebroplasty on osteoporotic thoracolumbar compression fracture and analysis of related factors affecting postoperative residual pain[J]. Chinese Journal of Bone and Joint Injury, 2023, 38(9): 957-960.
    [25]
    HOLYOAK D T, ANDRESHAK T G, HOPKINS T J, et al. Height restoration and sustainability using bilateral vertebral augmentation systems for vertebral compression fractures: a cadaveric study[J]. Spine J, 2022, 22(12): 2072-2081.
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