基于列线图构建骨质疏松压缩性骨折患者PVP术后发生残余痛的预测模型

Prediction Model of Residual Pain in Patients with Osteoporotic Compression Fracture After PVP Based on Nomogram

目的构建骨质疏松压缩性骨折(OVCF)患者经皮穿刺脊柱椎体成形术(PVP)后发生残余痛的列线图预测模型。方法选取2019年1月-2022年1月广信区人民医院行PVP治疗的114例OVCF患者,依据术后视觉模拟评分(VAS)分为残余痛组、无残余痛组,分析OVCF患者PVP术后残余痛的独立危险因素,依据其结果构建相关列线图预测模型,并予以验证。结果残余痛组患者41例,无残余痛组73例;两组BMI、术前骨密度、腰背筋膜损伤、椎体裂隙征、骨水泥注入量、骨水泥渗漏、骨水泥分布比较,差异有统计学意义(P<0.05);多因素Logistic分析显示,术前骨密度低、腰背筋膜损伤、椎体裂隙征、骨水泥未覆盖骨折线是OVCF患者PVP术后残余痛的独立危险因素(P<0.05);基于术前骨密度、腰背筋膜损伤、椎体裂隙征、骨水泥分布构建的OVCF患者PVP术后残余痛列线图预测模型C-index值为0.871。结论基于术前骨密度、腰背筋膜损伤、椎体裂隙征、骨水泥分布构建的OVCF患者PVP术后残余痛的列线图预测模型具有良好预测效能。

Objective To construct a nomogram prediction model for residual pain after percutaneous vertebroplasty(PVP)in patients with osteoporotic compression fracture(OVCF).Methods From January 2019 to January 2022,114 patients with OVCF who underwent PVP in Guangxin District People's Hospital were selected.According to the postoperative visual analogue scale(VAS),they were divided into residual pain group and non-residual pain group.The independent risk factors of residual pain after PVP in patients with OVCF were analyzed,and the relevant nomogram prediction model was constructed and verified according to the results.Results There were 41 patients in the residual pain group and 73 patients in the non-residual pain group.There were significant differences in BMI,preoperative bone mineral density,low back fascia injury,vertebral fissure sign,bone cement injection volume,bone cement leakage and bone cement distribution between the two groups(P<0.05).Multivariate logistic analysis showed that low preoperative bone mineral density,low back fascia injury,vertebral fissure sign,and bone cement not covering the fracture line were independent risk factors for residual pain after PVP in OVCF patients(P<0.05).The C-index value of the nomogram prediction model for residual pain after PVP in OVCF patients based on preoperative bone mineral density,low back fascia injury,vertebral fissure sign and bone cement distribution was 0.871.Conclusion The nomograph model for predicting PVP residual pain in OVCF patients based on preoperative bone mineral density,lumbar and dorsal fascia injury,vertebral fissure sign,and bone cement distribution has good predictive efficacy.