• Fanguo Lin, Yuye Zhang, Xiaomei Song, Yanping Niu, Peng Su, Jun Hua, and Yongming Sun.
• Department of Orthopedics, The Second Affiliated Hospital of Soochow University, Suzhou, China.
• Pain Physician. 2023 Jan 1; 26 (1): 535953-59.

BackgroundOsteoporotic vertebral compression fractures (OVCF) are common. A few patients with thoracic vertebral fracture show pain in the bilateral rib region but not at the fracture site. The point of specific tenderness in the rib region cannot be located. It is not clear whether percutaneous kyphoplasty (PKP) can relieve the pain in the bilateral rib region in these patients.ObjectiveTo check whether PKP can alleviate the rib region pain in thoracic vertebral fracture patients without local pain at the fractured vertebra.Study DesignRetrospective study.SettingThe study was carried out at a university hospital.MethodsWe performed a retrospective analysis of thoracic vertebral fracture patients admitted to our hospital for PKP surgery between January 2018 and June 2022. The main clinical manifestations of these patients were pain in the bilateral rib region but no local tenderness and percussion pain at the fractured vertebra. CT and MRI examinations of the thoracic vertebrae were performed after admission. PKP was performed under general anesthesia after no surgical contraindication. Visual analog scale (VAS) scores and heights of the anterior, middle, and posterior edges of the fractured vertebra before the surgery, one day after surgery, and one month after surgery were compared. Also, the Cobb angles formed by the upper and lower endplate of the fractured vertebra before the surgery, one day after surgery, and one month after surgery were compared.ResultsA total of 50 patients were included in this study (3 men and 47 women, with an average age of 72.46 ± 8.15 years), of which 7 patients had 2 segmental fractures, so a total of 57 vertebrae were included. The VAS scores on day one and one month after the surgery were significantly lower than that before the surgery. The heights of the anterior, middle, and posterior edges of the fractured vertebra on day one after the surgery were significantly higher than those before the surgery. The Cobb angle of the fractured vertebra on day one after the surgery was lower than that before the surgery. The vertebrae of 23 patients were examined using x-ray one month after the surgery. The heights of the anterior, middle, and posterior edges of the fractured vertebra one month after the surgery were also significantly higher than those before the surgery but significantly lower than those one day after the surgery. Also, the Cobb angle of the fractured vertebra one month after the surgery was significantly lower than that before the surgery.LimitationsThis was a retrospective study, which may be prone to selection and recall bias. Single-center non-controlled studies may also introduce bias.ConclusionThe exact location of the pain in the rib region caused by thoracic fracture cannot be identified usually. PKP can alleviate the rib region pain caused by the thoracic fracture.

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