{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:19:34Z","timestamp":1760059174718,"version":"build-2065373602"},"reference-count":19,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2025,5,24]],"date-time":"2025-05-24T00:00:00Z","timestamp":1748044800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Geriatrics"],"abstract":"<jats:p>Introduction: Vertebral Compression Fractures (VCF) are the most common vertebral fractures, usually osteoporotic, with rising incidence. The natural history of VCFs-related pain remains unclear, and treatment protocols are still being evaluated, ranging from conservative to surgical. Patient-reported measures have been proven inaccurate and carry significant biases. This study examines maximal tenderness location (MTL) to palpation and percussion on physical examination during VCF healing and the postoperative period. Methods: A prospective study included 40 patients treated for VCFs per the NICE guidelines (2013) from 2019 to 2021. Treatment was either conservative (n = 12) or surgical (n \u2212 28), Balloon Kyphoplasty (BKP). All patients\u2019 MTL were recorded in EMR (Electronic Medical Record) on every visit. BKP was offered for severe ongoing pain after a recent, unhealed vertebral fracture despite optimal pain management, progressive fracture collapse, or lack of union. Follow-up was six months. Pain evolution was analyzed using Kaplan\u2013Meier survival curves, Log-Rank tests, Mann\u2013Whitney U tests, t-tests, and logistic regression models. A p-value &lt; 0.05 was considered statistically significant. Results: 12 patients were treated conservatively, and 28 underwent BKP for T12-L2 VCFs, accounting for 75% of fractures, mostly single-level fractures. All initially suffered MTL over the VCF; BKP patients showed local VCF pain resolution after 3.5 weeks following surgery while lasting seven weeks under conservative treatment. Lumbosacral pain was more prevalent following BKP (OR = 4, p = 0.05) and developed earlier. Conclusions: This study is novel in relating physical examination findings to fracture age and treatment provided, suggesting that VCFs-related pain is a time-related shift from local fracture pain to lumbosacral pain. Patient-reported pain scales may not reliably distinguish between these varying pain patterns. These findings suggest that only local VCF pain should be considered for surgical treatment. Future studies evaluating VCF outcomes should address physical examination and not rely solely on patient-reported metrics.<\/jats:p>","DOI":"10.3390\/geriatrics10030071","type":"journal-article","created":{"date-parts":[[2025,5,25]],"date-time":"2025-05-25T20:39:36Z","timestamp":1748205576000},"page":"71","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pain Localization Shift During the Convalescence Period of Osteoporotic Vertebral Compression Fracture"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2975-9152","authenticated-orcid":false,"given":"Oded","family":"Hershkovich","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery, Wolfson Medical Center, Holon 5822012, Israel"},{"name":"Gray Faculty of Medical & Health Sciences, Tel Aviv University, Tel Aviv-Yafo 6997801, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7710-8106","authenticated-orcid":false,"given":"Mojahed","family":"Sakhnini","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Wolfson Medical Center, Holon 5822012, Israel"},{"name":"Gray Faculty of Medical & Health Sciences, Tel Aviv University, Tel Aviv-Yafo 6997801, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7968-7906","authenticated-orcid":false,"given":"Raphael","family":"Lotan","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Wolfson Medical Center, Holon 5822012, Israel"},{"name":"Gray Faculty of Medical & Health Sciences, Tel Aviv University, Tel Aviv-Yafo 6997801, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1111\/j.1532-5415.2000.tb02641.x","article-title":"Prevalent vertebral deformities predict mortality and hospitalization in older women with low bone mass","volume":"48","author":"Ensrud","year":"2000","journal-title":"J. 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