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

Verfasser / Beitragende:
[Pilar Peris, Jordi Blasco, Josep Carrasco, Angels Martinez-Ferrer, Juan Macho, Luis Román, Ana Monegal, Nuria Guañabens]
Ort, Verlag, Jahr:
2015
Enthalten in:
Calcified Tissue International, 96/2(2015-02-01), 89-96
Format:
Artikel (online)
ID: 605521646
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024 7 0 |a 10.1007/s00223-014-9940-x  |2 doi 
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245 0 0 |a Risk Factors for the Development of Chronic Back Pain After Percutaneous Vertebroplasty Versus Conservative Treatment  |h [Elektronische Daten]  |c [Pilar Peris, Jordi Blasco, Josep Carrasco, Angels Martinez-Ferrer, Juan Macho, Luis Román, Ana Monegal, Nuria Guañabens] 
520 3 |a 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 12months. 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%≥4months in VP vs. 40% in CT, P=0.03). On univariate analysis, female gender (OR 1.52; 95% CI 1.47-1.57, P<0.0001), multiple acute VF (OR 1.79; 95% CI 1.71-1.87, P<0.0001), VAS≥7 two months after treatment (OR 11.04; 95% CI 6.71-18.17, P<0.0001), and type of antiosteoporotic drug (teriparatide) (OR 0.12; 95% CI 0.03-0.60, P=0.0236) were risk factors of CBP development in both groups. In the multivariate analysis, the main risk factors were baseline and post-treatment VAS≥7, longer symptom onset time, and type of antiosteoporotic treatment. In conclusion, 23% of patients with symptomatic osteoporotic VF developed severe CBP independently of the type of treatment. Symptom onset time before VP and persistence of severe CBP after treatment were the main factors related to CBP with teriparatide treatment decreasing the risk of this complication. 
540 |a Springer Science+Business Media New York, 2014 
690 7 |a Vertebroplasty  |2 nationallicence 
690 7 |a Vertebral fracture  |2 nationallicence 
690 7 |a Chronic back pain  |2 nationallicence 
690 7 |a Fragility fracture  |2 nationallicence 
690 7 |a Osteoporotic fracture  |2 nationallicence 
700 1 |a Peris  |D Pilar  |u Rheumatology Department, CIBERehd, Hospital Clinic, Villarroel 170, 08036, Barcelona, Spain  |4 aut 
700 1 |a Blasco  |D Jordi  |u Neurointerventional Department, Hospital Clinic, Barcelona, Spain  |4 aut 
700 1 |a Carrasco  |D Josep  |u Public Health Department, University of Barcelona, Barcelona, Spain  |4 aut 
700 1 |a Martinez-Ferrer  |D Angels  |u Rheumatology Department, CIBERehd, Hospital Clinic, Villarroel 170, 08036, Barcelona, Spain  |4 aut 
700 1 |a Macho  |D Juan  |u Neurointerventional Department, Hospital Clinic, Barcelona, Spain  |4 aut 
700 1 |a Román  |D Luis  |u Neurointerventional Department, Hospital Clinic, Barcelona, Spain  |4 aut 
700 1 |a Monegal  |D Ana  |u Rheumatology Department, CIBERehd, Hospital Clinic, Villarroel 170, 08036, Barcelona, Spain  |4 aut 
700 1 |a Guañabens  |D Nuria  |u Rheumatology Department, CIBERehd, Hospital Clinic, Villarroel 170, 08036, Barcelona, Spain  |4 aut 
773 0 |t Calcified Tissue International  |d Springer US; http://www.springer-ny.com  |g 96/2(2015-02-01), 89-96  |x 0171-967X  |q 96:2<89  |1 2015  |2 96  |o 223 
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950 |B NATIONALLICENCE  |P 700  |E 1-  |a Peris  |D Pilar  |u Rheumatology Department, CIBERehd, Hospital Clinic, Villarroel 170, 08036, Barcelona, Spain  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Blasco  |D Jordi  |u Neurointerventional Department, Hospital Clinic, Barcelona, Spain  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Carrasco  |D Josep  |u Public Health Department, University of Barcelona, Barcelona, Spain  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Martinez-Ferrer  |D Angels  |u Rheumatology Department, CIBERehd, Hospital Clinic, Villarroel 170, 08036, Barcelona, Spain  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Macho  |D Juan  |u Neurointerventional Department, Hospital Clinic, Barcelona, Spain  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Román  |D Luis  |u Neurointerventional Department, Hospital Clinic, Barcelona, Spain  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Monegal  |D Ana  |u Rheumatology Department, CIBERehd, Hospital Clinic, Villarroel 170, 08036, Barcelona, Spain  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Guañabens  |D Nuria  |u Rheumatology Department, CIBERehd, Hospital Clinic, Villarroel 170, 08036, Barcelona, Spain  |4 aut 
950 |B NATIONALLICENCE  |P 773  |E 0-  |t Calcified Tissue International  |d Springer US; http://www.springer-ny.com  |g 96/2(2015-02-01), 89-96  |x 0171-967X  |q 96:2<89  |1 2015  |2 96  |o 223