Factors and Strategies for Poor Pain Relief after Vertebroplasty: A Literature Review

Author(s): Binbin Tang, Kang Liu, Xiaolin Shi, Yuliang Huang

Study Design: Literatures review

Objective: To search and review the causes and measures to Poor Pain Relief (PPR) after vertebroplasty for Osteoporotic Vertebral Compression Fractures (OVCFs) in short period postoperatively.

Summary of Background Data: Vertebroplasty are more and more common for OVCF patients. However, various treatments on postoperative residual pain have been reported heavily. The PPR has been disturbing many doctors and affects the symptoms of patients. Therefore, we reviewed relevant articles in an attempt to obtain meaningful evidence on factors and strategies for PPR.

Methods: We set the priority of comparatively observational clinical study for review. PubMed, Web of Science, Embase, CNKI, WanFang, and VIP were searched for the treatment of OVCFs with vertebroplasty and to evaluate the clinical efficacy.

Results: 817 references were electronically retrieved, 48 full-text papers were screened, and 36 studies were included. Seventeen trials presented factors for PPR, mainly including bone cement-related, operation-related and patient-related factors. Nineteen studies showed strategies for PPR, including anti-osteoporosis treatments, surgical operation improvement and addition of other therapies. 15 prospective, 19 retrospective and 2 meta-analyses comprised the systematic review. The quality of included studies was generally low, especially in some controlled studies with an unclear risk of bias.

Conclusions: Bone cement distribution and operative errors are main causes of PPR after vertebroplasty. Many therapeutic methods are available to relieve this pain and restore function but with sparse evidence. We still value and implement