Factors Contributing to Residual Low Back Pain after Osteoporotic Vertebral Fractures

Hiroyuki Inose, Tsuyoshi Kato, Shoichi Ichimura, Hiroaki Nakamura, Masatoshi Hoshino, Shinji Takahashi, Daisuke Togawa, Toru Hirano, Yasuaki Tokuhashi, Tetsuro Ohba, Hirotaka Haro, Takashi Tsuji, Kimiaki Sato, Yutaka Sasao, Masahiko Takahata, Koji Otani, Suketaka Momoshima, Takashi Hirai, Toshitaka Yoshii, Atsushi Okawa

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)


Although osteoporotic vertebral fractures (OVFs) are the most common type of osteoporotic fracture, few reports have investigated the factors contributing to residual low back pain in the chronic phase after OVFs by using radiographic evaluation. We examined the contribution of nonunion, vertebral deformity, and thoracolumbar alignment to the severity of residual low back pain post-OVF. This post hoc analysis of a prospective randomized study included 195 patients with a 48-week follow-up period. We investigated the associations between radiographic variables with the visual analog scale (VAS) scores for low back pain at 48 weeks post-OVF using a multiple linear regression model. Univariate analysis revealed that analgesic use, the local angle on magnetic resonance imaging, anterior vertebral body compression percentage on X-ray, and nonunion showed a significant association with VAS scores for low back pain. Multiple regression analysis produced the following equation: VAS for low back pain at 48 weeks = 15.49 + 0.29 × VAS for low back pain at 0 weeks + (with analgesics: +8.84, without analgesics: −8.84) + (union: −5.72, nonunion: −5.72). Among local alignment, thoracolumbar alignment, and nonunion, nonunion independently contributed to residual low back pain at 48 weeks post-OVF. A treatment strategy that reduces the occurrence of nonunion is desirable.

Original languageEnglish
Article number1566
JournalJournal of Clinical Medicine
Issue number6
Publication statusPublished - 2022 Mar 1


  • Alignment
  • Cobb angle
  • Nonunion
  • Osteoporotic vertebral fractures
  • Radiographic evaluation
  • Residual low back pain
  • Thoracolumbar alignment
  • Vertebral deformity
  • Visual analog scale

ASJC Scopus subject areas

  • General Medicine


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