A nomogram for postoperative pain relief in patients with osteoporotic vertebral compression fracture treated with polymethylmethacrylate bone cement

Abstract Osteoporotic vertebral compression fractures (OVCFs) can be painful. Percutaneous kyphoplasty (PKP) aims at strengthening the vertebra and reducing pain, but efficacy can vary among patients. The purpose of this study was to establish a risk prediction model for pain relief following PKP in...

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Main Authors: Shirong Lu, Xudong Xia, Xu Shi, Xiaoli Qin, Chunguang Wang, Wei Wei
Format: Article
Language:English
Published: Nature Portfolio 2025-01-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-85820-7
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author Shirong Lu
Xudong Xia
Xu Shi
Xiaoli Qin
Chunguang Wang
Wei Wei
author_facet Shirong Lu
Xudong Xia
Xu Shi
Xiaoli Qin
Chunguang Wang
Wei Wei
author_sort Shirong Lu
collection DOAJ
description Abstract Osteoporotic vertebral compression fractures (OVCFs) can be painful. Percutaneous kyphoplasty (PKP) aims at strengthening the vertebra and reducing pain, but efficacy can vary among patients. The purpose of this study was to establish a risk prediction model for pain relief following PKP in patients with OVCF. This retrospective study included 208 (training set) and 54 (validation set) OVCF patients who underwent bone cement treatment between January 2018 and October 2023. Based on postoperative VAS scores, patients were divided into two groups (0–2 and 3–6). Univariable and multivariable logistic regression identified significant factors affecting VAS scores, leading to the creation of a nomogram model. Internal validation was performed using the bootstrap method. The model’s performance and clinical value were evaluated using the area under the receiver operating characteristic curve (AUC), decision curve analysis (DCA), and calibration curves. Four predictors were identified: number of segments, PMMA dose, comorbidities, and central nervous system (CNS) medications. The AUC, DCA, and calibration curves demonstrated good model discrimination and accuracy. The clinical impact plot highlighted the model’s practical value. We developed and validated an intuitive nomogram model for predicting a postoperative VAS score ≤ 2, reflecting therapeutic efficacy in OVCF patients treated with PMMA. The model could be used for a more careful selection of patients suitable for PKP and who would benefit the most from PKP. The other patients should at least be advised of the risk of suboptimal pain control or directed toward other treatments.
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spelling doaj-art-3cf23a39fda446a7a26056ce09df15382025-01-19T12:24:23ZengNature PortfolioScientific Reports2045-23222025-01-0115111110.1038/s41598-025-85820-7A nomogram for postoperative pain relief in patients with osteoporotic vertebral compression fracture treated with polymethylmethacrylate bone cementShirong Lu0Xudong Xia1Xu Shi2Xiaoli Qin3Chunguang Wang4Wei Wei5Department of Orthopedics, Harbin 242 HospitalDepartment of Orthopedics, Harbin 242 HospitalDepartment of Orthopedics, Harbin 242 HospitalDepartment of Orthopedics, Harbin 242 HospitalDepartment of Orthopedics, Harbin 242 HospitalDepartment of Orthopedics, Harbin 242 HospitalAbstract Osteoporotic vertebral compression fractures (OVCFs) can be painful. Percutaneous kyphoplasty (PKP) aims at strengthening the vertebra and reducing pain, but efficacy can vary among patients. The purpose of this study was to establish a risk prediction model for pain relief following PKP in patients with OVCF. This retrospective study included 208 (training set) and 54 (validation set) OVCF patients who underwent bone cement treatment between January 2018 and October 2023. Based on postoperative VAS scores, patients were divided into two groups (0–2 and 3–6). Univariable and multivariable logistic regression identified significant factors affecting VAS scores, leading to the creation of a nomogram model. Internal validation was performed using the bootstrap method. The model’s performance and clinical value were evaluated using the area under the receiver operating characteristic curve (AUC), decision curve analysis (DCA), and calibration curves. Four predictors were identified: number of segments, PMMA dose, comorbidities, and central nervous system (CNS) medications. The AUC, DCA, and calibration curves demonstrated good model discrimination and accuracy. The clinical impact plot highlighted the model’s practical value. We developed and validated an intuitive nomogram model for predicting a postoperative VAS score ≤ 2, reflecting therapeutic efficacy in OVCF patients treated with PMMA. The model could be used for a more careful selection of patients suitable for PKP and who would benefit the most from PKP. The other patients should at least be advised of the risk of suboptimal pain control or directed toward other treatments.https://doi.org/10.1038/s41598-025-85820-7Postoperative painOsteoporosisVertebral compression fracturesNomogramPercutaneous kyphoplastyPMMA dose
spellingShingle Shirong Lu
Xudong Xia
Xu Shi
Xiaoli Qin
Chunguang Wang
Wei Wei
A nomogram for postoperative pain relief in patients with osteoporotic vertebral compression fracture treated with polymethylmethacrylate bone cement
Scientific Reports
Postoperative pain
Osteoporosis
Vertebral compression fractures
Nomogram
Percutaneous kyphoplasty
PMMA dose
title A nomogram for postoperative pain relief in patients with osteoporotic vertebral compression fracture treated with polymethylmethacrylate bone cement
title_full A nomogram for postoperative pain relief in patients with osteoporotic vertebral compression fracture treated with polymethylmethacrylate bone cement
title_fullStr A nomogram for postoperative pain relief in patients with osteoporotic vertebral compression fracture treated with polymethylmethacrylate bone cement
title_full_unstemmed A nomogram for postoperative pain relief in patients with osteoporotic vertebral compression fracture treated with polymethylmethacrylate bone cement
title_short A nomogram for postoperative pain relief in patients with osteoporotic vertebral compression fracture treated with polymethylmethacrylate bone cement
title_sort nomogram for postoperative pain relief in patients with osteoporotic vertebral compression fracture treated with polymethylmethacrylate bone cement
topic Postoperative pain
Osteoporosis
Vertebral compression fractures
Nomogram
Percutaneous kyphoplasty
PMMA dose
url https://doi.org/10.1038/s41598-025-85820-7
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