Abstract: BACKGROUND: Related studies have shown that bone density, postoperative infection, adjacent vertebral fracture, and lumbar fascial edema may be risk factors for lingering pain after vertebroplasty.
OBJECTIVE: To scrutinize the risk factors for lumbar fascia edema in osteoporotic vertebral compression fractures patients and investigate its influence on lingering pain after vertebroplasty.
METHODS: A retrospective analysis was conducted on 204 osteoporotic vertebral compression fractures patients who underwent percutaneous vertebroplasty at the Clinical Medical College of Yangzhou University from February to October 2022. Patients were categorized based on MRI findings into two groups: without lumbar fascia edema (84 cases) and with lumbar fascia edema (120 cases). Preoperative data, encompassing age, gender, height, weight, body mass index, bone density, serum total protein, serum albumin, inflammatory markers (C-reactive protein and erythrocyte sedimentation rate), degree of fracture compression, presence of prior compression fractures, fracture count, lumbar instability, and Japanese senile independence score were gathered. Postoperative follow-up recorded data such as the number of new vertebral fractures and visual analog scale scores were recorded. Logistic regression method was used to analyze the risk factors of lumbar fascial edema, and the receiver operating characteristic curve was used to determine whether the risk factors had relevant diagnostic significance.
RESULTS AND CONCLUSION: (1) Age, prior vertebral compression fractures, Japanese senile independence score score, and lumbar instability presence emerged as autonomous risk factors for lumbar fascia edema in osteoporotic vertebral compression fractures patients, with corresponding odds ratios of 2.76, 1.70, 2.56, and 4.74, respectively. (2) Employing a visual analog scale score of 4 at 1 month postoperatively to distinguish residual pain revealed 31 cases with residual pain in the lumbar fascia edema group, in contrast to only 8 cases in the non-fascia edema group (P < 0.01). (3) The fascia edema group exhibited a significantly higher visual analog scale score at 1 month postoperatively (2.12±1.35) compared to the group without fascia edema (1.67±1.08) (P < 0.01). (4) It is indicated that age, Japanese senile independence score, prior compression fractures, and lumbar instability presence independently contribute to lumbar fascia edema in osteoporotic vertebral compression fractures patients. Lumbar fascia edema emerges as a determinant of persistent pain in the lumbar region following percutaneous vertebroplasty in these patients.

Key words: lumbar fascia edema, osteoporosis, vertebral compression fracture, percutaneous vertebroplasty, MRI, risk factor, logistic regression analysis