关键词: 骨质疏松椎体压缩性骨折, 经皮椎体成形术, 牵涉痛, 危险因素, 骨水泥渗漏

Abstract: Objective To explore the occurrence and risk factors of referred pain (RP) in osteoporotic vertebral compression fracture (OVCF) after percutaneous vertebroplasty (PVP).Methods A retrospective analysis was performed on the clinical data of 198 patients with single-segment OVCF who underwent PVP in the hospital between January 2023 and December 2024.According to presence or absence of RP after PVP, patients were divided into RP group (36 cases) and non-RP group (162 cases).The occurrence of RP in OVCF patients after PVP was analyzed.The independent risk factors of RP after PVP were screened by univariate analysis and Logistic regression analysis.Results Among 198 OVCF patients after PVP, there were 36 cases cases (18.18%) with RP.The pain sites were mainly distributed in lumbar spinal cord, buttocks and lower extremities.The course of disease, proportions of thoracolumbar fracture, preoperative vertebral compression ≥25%, vacuum fissure sign, intraoperative use of lipidosome bupivacaine, asymmetry of bone cement diffusion and bone cement leakage in RP group were significantly higher than those in non-RP group, while preoperative BMD was significantly lower than that in non-RP group (P<0.05).Thoracolumbar fracture (OR=2.726, P=0.037), asymmetry of bone cement diffusion (OR=3.108, P=0.007) and bone cement leakage (OR=4.509, P=0.001) were all independent risk factors of RP in OVCF patients after PVP (P<0.05).Conclusion The incidence of RP is relatively higher in patients with OVCF after PVP.The thoracolumbar fracture, asymmetry of bone cement diffusion and bone cement leakage are all independent risk factors of postoperative RP.

Key words: osteoporotic vertebral compression fracture, percutaneous vertebroplasty, referred pain, risk factor, bone cement leakage