Development of a nomogram model for individualized prediction of residual pain risk after percutaneous kyphoplasty
Pan Daimei
Wu Zhihao
Huang Kaihua
Yu Jing
Kong Jingjing
Tang Yunyun
Sun Qiang
Wang Hongyu
Abstract：Objective To develop a nomogram model for individualized prediction of residual pain risk in patients after percu-taneous kyphoplasty(PKP),providing references for prevention and intervention of this population.Methods A total of 210 osteoporotic vertebral compression fracture(OVCF)patients undergoing PKP(June 2021-August 2023)were alloca-ted to residual pain(n=41)and non-residual pain(n=169)groups based on the absence or presence of pain status within six months postoperatively.Multivariate logistic stepwise regression analysis was employed to identify influencing factors,and a nomogram was constructed.Receiver operating characteristic(ROC)curves were used to evaluate the predictive per-formance of this model.Results The residual pain group had higher age,body mass index;higher proportions of≥2frac-tured vertebrae,thoracolumbar fascia injury,intravertebral cleft sign,and clustered bone cement distribution;but lower bone mineral density and bone cement volume per vertebra than the non-residual pain group,with statistically significant differences(P＜0.05).Multivariate logistic stepwise regression analysis identified bone mineral density(OR=2.450,95％CI:1.630-3.683),thoracolumbar fascia injury(OR=2.113,95％CI:1.479-3.018),intravertebral cleft sign(OR=2.843,95％CI:1.844-4.385),bone cement volume per vertebra(OR=2.368,95％CI:1.587-3.532),and bone cement distribution(OR=3.149,95％CI:1.983-5.001)as independent influencing factors(P＜0.05).The nomo-gram model for individualized prediction of residual pain risk in patients after PKP achieved a C-index of 0.881(95％CI:0.823-0.934).The area under the curve(AUC)of the nomogram for predicting residual pain was 0.874(95％CI:0.821-0.927),with 68.16％specificity and 91.47％sensitivity.Conclusion Bone mineral density,thoracolumbar fascia injury,intraver-tebral cleft sign,bone cement volume per vertebra,and bone cement distribution are independent factors influencing residual pain af-ter PKP.The constructed nomogram established based on the above factors demonstrates high predictive value.
Keywords：Osteoporotic vertebral compression fracturePercutaneous kyphoplastyResidual painRisk factorsNomogram
Publication Date：2025-08-20
Online Publishing Date：2025-12-09(First online date of this platform, not the publication date of the document)
Pages：6( 71-76 )