Risk factors of residual back pain after vertebral augmentation in osteoporotic vertebral compression fracture patients: a systematic review and meta-analysis
Bibliographic record
Abstract
BACKGROUND: Residual back pain (RBP) following vertebral augmentation negatively impacts clinical satisfaction and compromises both the physical and psychological well-being of affected patients. This meta-analysis aimed to identify risk factors associated with RBP after vertebral augmentation in patients with osteoporotic vertebral compression fractures (OVCF). METHODS: We searched literature in the PubMed, Embase, Web of Science and Cochrane Library. PRISMA guidelines were followed in this review. The Newcastle-Ottawa Scale (NOS) were used to evaluate the quality of included studies. Odds ratio (OR), mean difference (MD) and 95% confidence interval (CI) of potential risk factors were calculated via RevMan5.4. RESULTS: A total of 11 studies and 3290 patients were included in this meta-analysis. 12 risk factors were assessed and the outcome showed that lower BMD (MD = 0.39, 95% CI 0.27 ~ 0.52, p < 0.01), lower BMI (MD = -1.22, 95% CI -2.38 ~ -0.06, p = 0.04), depression (OR = 2.72, 95% CI 1.48 ~ 5.01, p < 0.01), adjacent vertebral fracture (OR = 2.53, 95% CI 1.42 ~ 4.50, p < 0.01), posterior fascia injury (OR = 3.94, 95% CI 3.10 ~ 5.00, p < 0.01), intravertebral vacuum cleft (OR = 2.33, 95% CI 1.56 ~ 3.50, p < 0.01), severe paraspinal muscle degeneration (OR = 6.25, 95% CI 4.09 ~ 9.53, p < 0.01), facet joint violation (OR = 7.71, 95% CI 3.50 ~ 17.00, p < 0.01), unsatisfied bone cement distribution (OR = 2.82, 95% CI 1.67 ~ 4.76, p < 0.01), less bone cement volume (MD = -0.24, 95% CI -0.45 ~ -0.03, p = 0.02), less recovery rate of anterior vertebral height (MD = -3.46, 95% CI -6.22 ~ -6.09, p = 0.01), less postoperative local kyphosis correction rate (MD = -4.74, 95% CI -6.43 ~ -3.06, p < 0.01) were associated with postoperative RBP in OVCF patients. CONCLUSION: Lower BMD, lower BMI, depression, adjacent vertebral fracture, posterior fascia injury, intravertebral vacuum cleft, severe paraspinal muscle degeneration, facet joint violation, unsatisfied bone cement distribution, less bone cement volume, less recovery rate of anterior vertebral height, and less postoperative local kyphosis correction rate were associated with an increased risk of RBP after vertebral augmentation in OVCF patients. Early identification and targeted management of high-risk patients may help reduce RBP incidence.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.008 | 0.017 |
| Meta-epidemiology (narrow) | 0.003 | 0.001 |
| Meta-epidemiology (broad) | 0.016 | 0.036 |
| Bibliometrics | 0.005 | 0.006 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.001 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".