| 侯宝生,姜婷,罗吉,等.胸腰段OVCF首次行PVP术后发生短期残余腰痛预测模型的开发与验证.骨科,2026,17(4): 325-331. |
| 胸腰段OVCF首次行PVP术后发生短期残余腰痛预测模型的开发与验证 |
| Development and validation of a prediction model for short-term residual low back pain after initial percutaneous vertebroplasty in thoracolumbar osteoporotic vertebral compression fractures |
| 投稿时间：2025-12-28 |
| DOI：10.3969/j.issn.1674-8573.2026.04.004 |
| CN KeyWords: 骨质疏松 椎体压缩性骨折 经皮椎体成形术 残余腰痛 风险因素 列线图 |
| EN KeyWords: Osteoporosis Vertebral compression fractures Percutaneous vertebroplasty Residual low back pain Risk factors Nomogram |
| Fund Project:上海市高级中西医结合人才培养项目[ZY(2018-2020)-RCPY-2014] |
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| CN Abstract: |
| 目的 开发并验证一个用于预测胸腰段骨质疏松性椎体压缩骨折（OVCF）患者首次接受经皮椎体成形术（PVP）后发生短期残余腰痛（SRBP）风险的列线图（Nomogram）模型，以辅助临床进行个体化风险评估和干预。方法 本研究回顾性分析了2021年1月至2025年10月期间在上海市同仁医院行PVP手术的272例OVCF患者的临床资料。通过两组间差异性分析和多因素Logistic回归分析筛选出PVP术后发生SRBP的独立危险因素。基于这些危险因素，构建出直观的Nomogram预测模型。通过受试者工作特征（ROC）曲线、校准曲线和临床决策曲线分析（DCA）对模型的区分度、校准度和临床实用性进行内部验证。结果 272例患者中，有31例（11.40%）发生SRBP。多因素Logistic回归分析显示，胸腰筋膜损伤（OR=5.82）、骨密度T值（OR=0.02）、术前伤椎楔形角（OR=1.36）以及骨水泥填充率（OR=0.65）是SRBP的独立影响因素。基于这四个因素构建的Nomogram预测模型在内部验证中表现出优秀的区分能力（AUC=0.95）、良好的校准度（Hosmer-Lemeshow检验，P=0.506）和满意的临床净收益。结论 本研究成功开发并验证了一个整合了胸腰筋膜损伤、骨密度T值、术前伤椎楔形角和骨水泥填充率的Nomogram模型。该模型能有效预测胸腰段OVCF患者首次PVP术后发生SRBP的个体化风险，有助于临床医生识别高风险患者并制定个性化的围手术期管理策略。 |
| EN Abstract: |
| Objective To develop and validate a Nomogram for predicting the risk of short-term residual low back pain (SRBP) after the initial percutaneous vertebroplasty (PVP) in patients with thoracolumbar osteoporotic vertebral compression fractures (OVCF), thereby facilitating individualized risk assessment and intervention in clinical practice. Methods The clinical data of 272 patients with OVCF who underwent PVP at Shanghai Tongren Hospital between January 2021 and October 2025 were retrospectively analyzed. Univariate analysis and multivariate Logistic regression were performed to identify independent predictors of SRBP after PVP. A Nomogram prediction model was then developed based on these predictors. The model's discrimination, calibration, and clinical utility were assessed using receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis (DCA), respectively. Results SRBP occurred in 31 of the 272 patients (11.40%). Multivariate Logistic regression identified thoracolumbar fascia injury (OR=5.82), lower bone mineral density T-score (OR=0.02), larger preoperative fractured vertebral wedge angle (OR=1.36), and lower bone cement filling rate (OR=0.65) as independent influencing factors for SRBP. The Nomogram model constructed on the basis of these four variables showed excellent discrimination with an AUC of 0.95, good calibration (Hosmer-Lemeshow test, P=0.506), and favorable clinical utility upon internal validation. Conclusion This study successfully developed and validated a Nomogram model integrating thoracolumbar fascia injury, bone mineral density T-score, preoperative fractured vertebral wedge angle, and bone cement filling rate. This model effectively predicts the individualized risk of SRBP after the initial PVP in patients with thoracolumbar OVCF, thereby assisting clinicians in identifying high-risk patients and formulating personalized perioperative management strategies. |
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