骨质疏松性胸腰椎压缩骨折椎体成形术后残余背痛影响因素的研究进展

Research Progress on the Influencing Factors of Residual Back Pain after Vertebroplasty for Osteoporotic Thoracolumbar Compression Fractures

摘要: 经皮椎体成形术已成为骨质疏松胸腰椎压缩骨折的普遍采用治疗方法。随着现代医学技术的迅速发展与广泛应用，术后腰背部残留疼痛的发病率呈现出上升趋势，这一现象不仅显著阻碍了患者的早期活动能力，延缓了术后康复进程，还直接加重了患者的经济压力，同时也对提高患者满意度构成了挑战。在分析严重骨质疏松术后残余腰背痛的原因时，应综合考虑多个关键因素，包括但不限于矢状面失衡、腰背部软组织与筋膜的病变、椎体裂隙现象及其骨水泥分布的非均匀性、骨水泥的泄漏情况、手术后的感染风险、术后椎体再次发生骨折的可能性以及患者的心理状态等多维度影响。这些因素相互作用，共同作用于患者的康复过程，从而影响其腰背疼痛的持续存在与恢复情况。本文就患者因素、针对手术过程中涉及的各项因素进行全面的归纳与总结，旨在为优化手术效果、促进患者术后生活质量的提升提供科学依据与实践指导。

Abstract: Percutaneous vertebroplasty has become a commonly adopted treatment method for osteoporotic thoracolumbar compression fractures. With the rapid development and wide application of modern medical technology, the incidence of residual pain in the lower back after surgery is on the rise. This phenomenon not only significantly hinders the early activity ability of patients, delays the postoperative rehabilitation process, but also directly increases the economic pressure on patients, and at the same time poses a challenge to improving patient satisfaction. When analyzing the causes of residual low back pain after surgery due to severe osteoporosis, multiple key factors should be comprehensively considered, including but not limited to sagittal plane imbalance, lesions of soft tissues and fascia in the lumbar and dorsal regions, the phenomenon of vertebral fractures and the non-uniformity of bone cement distribution, the leakage of bone cement, the risk of infection after surgery, the possibility of recurrence of vertebral fractures after surgery, and the psychological state of patients, among other multi-dimensional influences. These factors interact with each other and jointly affect the patient’s rehabilitation process, thereby influencing the persistence and recovery of their low back pain. This article comprehensively summarizes and generalizes the patient factors and various factors involved in the surgical process, aiming to provide a scientific basis and practical guidance for optimizing surgical outcomes and improving the postoperative quality of life of patients.