Identifying early risk factors for chronic pain development following vertebral fractures: a single-center prospective cohort study

识别椎体骨折后慢性疼痛发生的早期危险因素:一项单中心前瞻性队列研究

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Abstract

STUDY DESIGN: Longitudinal cohort study. PURPOSE: To investigate factors associated with chronic pain (CP) development following vertebral fracture (VF). OVERVIEW OF LITERATURE: Factors contributing to CP development after VFs are not well characterized. METHODS: Hospitalized patients with acute VFs underwent assessment of vertebral morphology and paraspinal muscles. Two weeks post-admission, patients were evaluated for pain intensity (using the Verbal Rating Scale [VRS]), pain sensitivity (Pressure Pain Threshold [PPT] and Conditioned Pain Modulation), psychological factors, physical function, and activity levels. At 12 weeks, patients were categorized into CP and non-CP (NCP) groups based on VRS scores. Between-group comparisons and logistic regression analysis were performed to identify predictors of CP development. RESULTS: The CP group exhibited significantly lower remote PPT and reduced low-intensity physical activity time, but higher Pain Catastrophizing Scale rumination scores and prolonged 5-Times Sit-to-Stand Test (5SST) compared to the NCP group. Logistic regression identified prolonged 5SST and reduced low-intensity physical activity as independent predictors of CP development. CONCLUSIONS: Prolonged 5SST and reduced low-intensity physical activity may predict CP development after VFs. Early assessment of these factors may facilitate CP risk screening in hospitalized patients with VFs.

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