Association between thoracolumbar fascia injury and residual back pain following percutaneous vertebral augmentation: a systematic review and meta-analysis

ObjectiveTo evaluate the association between a thoracolumbar fascia injury (TLFI) and the development of residual back pain (RBP) following percutaneous vertebral augmentation (PVA).BackgroundOsteoporotic vertebral compression fractures (OVCF) commonly affect elderly individuals and those with osteo...

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Main Authors: Abdiaziz Ahmed Mohamed, Xu Xuyang, Zhang Zhiqiang, Jianghu Chen
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-04-01
Series:Frontiers in Endocrinology
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Online Access:https://www.frontiersin.org/articles/10.3389/fendo.2025.1532355/full
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author Abdiaziz Ahmed Mohamed
Abdiaziz Ahmed Mohamed
Xu Xuyang
Xu Xuyang
Zhang Zhiqiang
Jianghu Chen
Jianghu Chen
author_facet Abdiaziz Ahmed Mohamed
Abdiaziz Ahmed Mohamed
Xu Xuyang
Xu Xuyang
Zhang Zhiqiang
Jianghu Chen
Jianghu Chen
author_sort Abdiaziz Ahmed Mohamed
collection DOAJ
description ObjectiveTo evaluate the association between a thoracolumbar fascia injury (TLFI) and the development of residual back pain (RBP) following percutaneous vertebral augmentation (PVA).BackgroundOsteoporotic vertebral compression fractures (OVCF) commonly affect elderly individuals and those with osteoporosis, leading to pain and limited mobility. Percutaneous vertebral augmentation provides immediate pain relief and stabilization of the fractures. However, some patients experience residual pain after the treatment. Although recent studies have suggested a potential association, the role of TLFI in RBP remains inconclusive. The aim of this meta-analysis was to evaluate this association.MethodsA thorough search was performed across the PubMed, Medline, Embase, Web of Science, and Cochrane Library databases from inception to 31 December 2024 to identify studies examining the link between TLFI and RBP following PVA. A random-effects model was used to combine the outcome data to account for the potential heterogeneity among the included studies.ResultsThis meta-analysis included 13 studies with a total of 4,542 participants and a TLFI incidence rate of 28%. Univariate analysis indicated that patients with a TLFI were significantly more likely to develop RBP compared to those without a TLFI, with an odds ratio (OR) of 4.19 (95% CI: 2.49 to 7.05, I² = 76.9%). The sensitivity analysis identified two studies as significant influential outliers that contributed to the majority of the observed heterogeneity. Excluding these studies resulted in an OR of 4.62 (95% CI: 3.61 to 5.92, I² = 0%). The multivariate analysis confirmed a strong association between TLFI and RBP after adjusting for confounders and other risk factors, with an OR of 4.57 (95% CI: 3.28 to 6.37, I² = 81.5%). The sensitivity analysis identified three studies as significant influential outliers, and excluding them resulted in an OR of 4.79 (95% CI: 3.76 to 6.11, I² = 0%) with no heterogeneity. This finding further confirms the association with a more homogenous overall effect estimate.ConclusionThe pooled effect size of both univariate and multivariate analyses consistently demonstrated that a TLFI significantly increased the risk of developing RBP after PVA regardless of other related risk factors. Recognizing fascia injury as a potential source of postoperative pain in clinical practice could enhance the care of these patients and mitigate postoperative pain.
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spelling doaj-art-0862df97c03c49d8997f4dd79c5b99bf2025-08-20T03:14:52ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922025-04-011610.3389/fendo.2025.15323551532355Association between thoracolumbar fascia injury and residual back pain following percutaneous vertebral augmentation: a systematic review and meta-analysisAbdiaziz Ahmed Mohamed0Abdiaziz Ahmed Mohamed1Xu Xuyang2Xu Xuyang3Zhang Zhiqiang4Jianghu Chen5Jianghu Chen6Department of Orthopedics, Northern Jiangsu People’s Hospital Affiliated Hospital to Yangzhou University, Yangzhou, Jiangsu, ChinaMedical College of Yangzhou University, Yangzhou, Jiangsu, ChinaDepartment of Orthopedics, Northern Jiangsu People’s Hospital Affiliated Hospital to Yangzhou University, Yangzhou, Jiangsu, ChinaMedical College of Yangzhou University, Yangzhou, Jiangsu, ChinaDepartment of Orthopedics, Northern Jiangsu People’s Hospital Affiliated Hospital to Yangzhou University, Yangzhou, Jiangsu, ChinaDepartment of Orthopedics, Northern Jiangsu People’s Hospital Affiliated Hospital to Yangzhou University, Yangzhou, Jiangsu, ChinaYangzhou Clinical Medical College of Xuzhou Medical University, Xuzhou, Jiangsu, ChinaObjectiveTo evaluate the association between a thoracolumbar fascia injury (TLFI) and the development of residual back pain (RBP) following percutaneous vertebral augmentation (PVA).BackgroundOsteoporotic vertebral compression fractures (OVCF) commonly affect elderly individuals and those with osteoporosis, leading to pain and limited mobility. Percutaneous vertebral augmentation provides immediate pain relief and stabilization of the fractures. However, some patients experience residual pain after the treatment. Although recent studies have suggested a potential association, the role of TLFI in RBP remains inconclusive. The aim of this meta-analysis was to evaluate this association.MethodsA thorough search was performed across the PubMed, Medline, Embase, Web of Science, and Cochrane Library databases from inception to 31 December 2024 to identify studies examining the link between TLFI and RBP following PVA. A random-effects model was used to combine the outcome data to account for the potential heterogeneity among the included studies.ResultsThis meta-analysis included 13 studies with a total of 4,542 participants and a TLFI incidence rate of 28%. Univariate analysis indicated that patients with a TLFI were significantly more likely to develop RBP compared to those without a TLFI, with an odds ratio (OR) of 4.19 (95% CI: 2.49 to 7.05, I² = 76.9%). The sensitivity analysis identified two studies as significant influential outliers that contributed to the majority of the observed heterogeneity. Excluding these studies resulted in an OR of 4.62 (95% CI: 3.61 to 5.92, I² = 0%). The multivariate analysis confirmed a strong association between TLFI and RBP after adjusting for confounders and other risk factors, with an OR of 4.57 (95% CI: 3.28 to 6.37, I² = 81.5%). The sensitivity analysis identified three studies as significant influential outliers, and excluding them resulted in an OR of 4.79 (95% CI: 3.76 to 6.11, I² = 0%) with no heterogeneity. This finding further confirms the association with a more homogenous overall effect estimate.ConclusionThe pooled effect size of both univariate and multivariate analyses consistently demonstrated that a TLFI significantly increased the risk of developing RBP after PVA regardless of other related risk factors. Recognizing fascia injury as a potential source of postoperative pain in clinical practice could enhance the care of these patients and mitigate postoperative pain.https://www.frontiersin.org/articles/10.3389/fendo.2025.1532355/fullfascia injuryosteoporosiscompression fracturemeta-analysisfragility fractureresidual back pain
spellingShingle Abdiaziz Ahmed Mohamed
Abdiaziz Ahmed Mohamed
Xu Xuyang
Xu Xuyang
Zhang Zhiqiang
Jianghu Chen
Jianghu Chen
Association between thoracolumbar fascia injury and residual back pain following percutaneous vertebral augmentation: a systematic review and meta-analysis
Frontiers in Endocrinology
fascia injury
osteoporosis
compression fracture
meta-analysis
fragility fracture
residual back pain
title Association between thoracolumbar fascia injury and residual back pain following percutaneous vertebral augmentation: a systematic review and meta-analysis
title_full Association between thoracolumbar fascia injury and residual back pain following percutaneous vertebral augmentation: a systematic review and meta-analysis
title_fullStr Association between thoracolumbar fascia injury and residual back pain following percutaneous vertebral augmentation: a systematic review and meta-analysis
title_full_unstemmed Association between thoracolumbar fascia injury and residual back pain following percutaneous vertebral augmentation: a systematic review and meta-analysis
title_short Association between thoracolumbar fascia injury and residual back pain following percutaneous vertebral augmentation: a systematic review and meta-analysis
title_sort association between thoracolumbar fascia injury and residual back pain following percutaneous vertebral augmentation a systematic review and meta analysis
topic fascia injury
osteoporosis
compression fracture
meta-analysis
fragility fracture
residual back pain
url https://www.frontiersin.org/articles/10.3389/fendo.2025.1532355/full
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