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[Cause analysis of back pain after vertebroplasty or kyphoplasty]
Yonggang Xing1, Guilin Zhang1, Wei Tian2
1Department of Spine Surgery, Beijing Jishuitan Hospital, Beijing 100035, China.
Objective:
To analyze the causes of back pain after vertebroplasty or kyphoplasty.
Methods:
1 863 patients with back pain who underwent vertebroplasty or kyphoplasty from Jan. 2004 to Dec. 2014 in Department of Spine Surgery, Beijing Jishuitan Hospital, were followed up for least 3 months after surgery with their back pain evaluated by VAS scores. Related information including preoperative, operative and postoperative factors was gathered. The VAS at last follow-up over 5 or the symptom relief less than 50% was considered as non-relieved, the correlations between the symptom relief and potential influencing factors were analyzed by the Spearman correlation.
Results:
Symptom relief was only correlated with postoperative complications (P<0.001). The back pain in 283 cases (15.2%) had not been relieved. Among them, 87 cases got fractures in other vertebrae (adjacent vertebrae in 67 cases, non-adjacent vertebrae in 20 cases); 3 cases got nonunion in the operated vertebrae; 1 case got postoperative infection; 6 cases got misdiagnosis and the other 186 cases had no known causes for the unrelieved pain.
Conclusions:
Postoperative back pain after vertebroplasty or kyphoplasty may have variable causes, and some of which have not been entirely understood. If the symptoms are not alleviated or even aggravate after active symptomatic treatment and anti-osteoporotic therapy, underlying causes such as re-fracture, nonunion, infection, pathologic fracture should be sought out.
