Low Back Pain on Movement 2 Weeks Postinjury of Osteoporotic Vertebral Fracture Can Predict a Short-Term Prognosis

Abstract

Introduction: Previous studies have reported that conservative treatment for osteoporotic vertebral fractures (OVF) results in high bone union rates. However, other factors, including complications, decreased activities of daily living (ADL), and length of hospital stay, have not been fully evaluated.

Methods: A total of 166 OVF patients who were conservatively treated in our hospital from April 2015 to March 2017 were included in this study. Among these, 16 cases with 5 or higher Numerical Rating Scale (NRS) of low back pain at the beginning of the movement 2 weeks postinjury were defined as the poor group. On the other hand, 150 cases with less than 5 NRS were defined as the poor group. Changes in NRS, length of hospital stay, walking ability decline rate, and complication rate were compared in both the groups.

Results: Significant differences were found between the good and poor groups in terms of NRS (median [interquartile range]) at 1, 2, and 4 weeks postinjury (7 [6, 7.3] vs 6 [5, 7], 6.5 [6, 8] vs 2 [2, 3], 5.5 [4. 8, 6.3] vs 1 [1, 2], respectively), except at admission (8 [7, 9] vs 8 [8, 9]).

Hospitalization days were 51 [44-61] days in the good group and 28 [24-32] days in the poor group, walking ability decline rates were 38% and 4%, the medical complication rates were 56% and 10%, and other adverse events were 38% and 8%, respectively, showing significant differences between the two groups.

Conclusions: While treating OVF in the elderly, the evaluation of low back pain during movement 2 weeks postinjury can be a useful index to predict early recovery of ADL and extension of healthy life expectancy.