Abstract

Objective: A few patients with thoracolumbar Osteoporotic Vertebral Compression Fracture (OVCF) only report pain in the lumbosacral region, which was far from the level of the fractured vertebra. The study aimed to assess the therapeutic efficacy of Percutaneous Vertebroplasty (PVP) in patients with thoracolumbar OVCF who presented with Distal Lumbosacral Pain (DLP), as well as investigate the potential underlying mechanisms of DLP.

Methods: Sixty-nine thoracolumbar OVCF patients who exclusively reported pain in the lumbosacral region of the lower back or buttock were enrolled in the LS group. In a 1:2 ratio, 138 patients who exclusively reported thoracolumbar pain localized at the level of the fractured vertebra were selected for the control group (TL group). Clinical outcomes were evaluated utilizing the Visual Analog Scale (VAS) and Chinese modiied Oswestry Disability Index (CMODI) scores. Radiographic assessment included measurements of vertebral height and Cobb angle.

Results: The VAS and CMODI scores, Cobb angle, and anterior and middle vertebral heights demonstrated significant improvement following surgery in both groups (P<0.05). No significant differences were observed between the two groups in terms of postoperative CMODI scores, Cobb angle, and anterior and middle vertebral heights (P>0.05). However, the LS group exhibited lower preoperative anterior and middle vertebral heights compared to the TL group (P=0.039 and 0.043, respectively). Additionally, there were higher VAS scores at 2 days and 1-month post-operation (both P<0.0001).

Conclusion: Percutaneous Vertebroplasty (PVP) can alleviate pain in the distal lumbosacral area caused by thoracolumbar OVCF. Excessive reduction in vertebral height may pose a potential risk for the emergence of lumbosacral pain. Patients with lumbosacral pain experienced a relatively inferior short-term pain relief following surgery compared to those with thoracolumbar pain.

Keywords:  Osteoporotic Vertebral Compression Fracture (OVCF); Distal lumbosacral pain; Lumbosacral pain referred pain; Percutaneous Vertebroplasty (PVP)