{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T22:10:50Z","timestamp":1781561450865,"version":"3.54.5"},"reference-count":25,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2022,3,12]],"date-time":"2022-03-12T00:00:00Z","timestamp":1647043200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>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 \u00d7 VAS for low back pain at 0 weeks + (with analgesics: +8.84, without analgesics: \u22128.84) + (union: \u22125.72, nonunion: \u22125.72). 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.<\/jats:p>","DOI":"10.3390\/jcm11061566","type":"journal-article","created":{"date-parts":[[2022,3,13]],"date-time":"2022-03-13T22:29:43Z","timestamp":1647210583000},"page":"1566","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Factors Contributing to Residual Low Back Pain after Osteoporotic Vertebral Fractures"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4195-2545","authenticated-orcid":false,"given":"Hiroyuki","family":"Inose","sequence":"first","affiliation":[{"name":"Department of Orthopaedic and Trauma Research, Graduate School, Tokyo Medical and Dental University, Tokyo 108-0075, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsuyoshi","family":"Kato","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Ome Municipal General Hospital, Tokyo 198-0042, Japan"},{"name":"Department of Orthopaedics, Graduate School, Tokyo Medical and Dental University, Tokyo 108-0075, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shoichi","family":"Ichimura","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Kyorin University, Tokyo 181-8611, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroaki","family":"Nakamura","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Graduate School of Medicine, Osaka City University, Osaka 545-8585, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masatoshi","family":"Hoshino","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Graduate School of Medicine, Osaka City University, Osaka 545-8585, Japan"},{"name":"Department of Orthopedic Surgery, Osaka City General Hospital, Osaka 534-0021, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6906-5406","authenticated-orcid":false,"given":"Shinji","family":"Takahashi","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Graduate School of Medicine, Osaka City University, Osaka 545-8585, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daisuke","family":"Togawa","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Hamamatsu University of Medicine, Shizuoka 431-3192, Japan"},{"name":"Departments of Orthopaedics and Rheumatology, Kinki University Nara Hospital, Nara 630-0293, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toru","family":"Hirano","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Niigata University Medical and Dental Hospital, Niigata 951-8520, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9098-6173","authenticated-orcid":false,"given":"Yasuaki","family":"Tokuhashi","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Nihon University, Tokyo 173-8610, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tetsuro","family":"Ohba","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Yamanashi, Yamanashi 409-3898, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5630-9600","authenticated-orcid":false,"given":"Hirotaka","family":"Haro","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Yamanashi, Yamanashi 409-3898, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takashi","family":"Tsuji","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Kitasato University Kitasato Institute Hospital, Tokyo 108-8642, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimiaki","family":"Sato","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Kurume University School of Medicine, Kurume University, Fukuoka 830-0011, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yutaka","family":"Sasao","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Graduate School, School of Medicine, St. Marianna University, Kanagawa 216-8511, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahiko","family":"Takahata","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Hokkaido University Graduate School of Medicine, Hokkaido 060-8638, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8409-9623","authenticated-orcid":false,"given":"Koji","family":"Otani","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suketaka","family":"Momoshima","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Radiology, Center for Preventive Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6200-0100","authenticated-orcid":false,"given":"Takashi","family":"Hirai","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Graduate School, Tokyo Medical and Dental University, Tokyo 108-0075, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshitaka","family":"Yoshii","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Graduate School, Tokyo Medical and Dental University, Tokyo 108-0075, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsushi","family":"Okawa","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Graduate School, Tokyo Medical and Dental University, Tokyo 108-0075, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,3,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"221.e1","DOI":"10.1016\/j.amjmed.2015.09.020","article-title":"Vertebral Fractures: Clinical Importance and Management","volume":"129","author":"Kendler","year":"2016","journal-title":"Am. J. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1547","DOI":"10.1359\/jbmr.2003.18.8.1547","article-title":"Fracture prediction from bone mineral density in Japanese men and women","volume":"18","author":"Fujiwara","year":"2003","journal-title":"J. Bone Miner. Res."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Inose, H., Kato, T., Nakamura, H., Hoshino, M., Togawa, D., Hirano, T., Tokuhashi, Y., Ohba, T., Haro, H., and Tsuji, T. (2020). Predictors for quality of life improvement after acute osteoporotic vertebral fracture: Results of post hoc analysis of a prospective randomized study. Qual. Life Res.","DOI":"10.1007\/s11136-020-02629-9"},{"key":"ref_4","first-page":"44","article-title":"Diagnosis and Management of Vertebral Compression Fractures","volume":"94","author":"McCarthy","year":"2016","journal-title":"Am. Fam. Physician"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Inose, H., Kato, T., Shirasawa, S., Takahashi, S., Hoshino, M., Yamato, Y., Matsukura, Y., Hirai, T., Yoshii, T., and Okawa, A. (2021). Time Course of Acute Vertebral Fractures: A Prospective Multicenter Cohort Study. J. Clin. Med., 10.","DOI":"10.3390\/jcm10245961"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1002\/jbmr.5650070214","article-title":"Incidence of clinically diagnosed vertebral fractures: A population-based study in Rochester, Minnesota, 1985-1989","volume":"7","author":"Cooper","year":"1992","journal-title":"J. Bone Miner. Res."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"E760","DOI":"10.1097\/BRS.0000000000003422","article-title":"Is Bone Nonunion, Vertebral Deformity, or Spinopelvic Malalignment the Best Therapeutic Target for Amelioration of Low Back Pain After Osteoporotic Vertebral Fracture?","volume":"45","author":"Iwata","year":"2020","journal-title":"Spine"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Kato, T., Inose, H., Ichimura, S., Tokuhashi, Y., Nakamura, H., Hoshino, M., Togawa, D., Hirano, T., Haro, H., and Ohba, T. (2019). Comparison of Rigid and Soft-Brace Treatments for Acute Osteoporotic Vertebral Compression Fracture: A Prospective, Randomized, Multicenter Study. J. Clin. Med., 8.","DOI":"10.3390\/jcm8020198"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1007","DOI":"10.1017\/S0033291700009934","article-title":"Clinical applications of visual analogue scales: A critical review","volume":"18","author":"McCormack","year":"1988","journal-title":"Psychol. Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1186\/1751-0473-3-17","article-title":"Purposeful selection of variables in logistic regression","volume":"3","author":"Bursac","year":"2008","journal-title":"Source Code Biol. Med."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Kasl, S.V., and Jones, B.A. (2003). An epidemiological perspective on research design, measurement, and surveillance strategies. Handbook of Occupational Health Psychology, American Psychological Association.","DOI":"10.1037\/10474-018"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Lafage, R., Schwab, F., Elysee, J., Smith, J.S., Alshabab, B.S., Passias, P., Klineberg, E., Kim, H.J., Shaffrey, C., and Burton, D. (2021). Surgical Planning for Adult Spinal Deformity: Anticipated Sagittal Alignment Corrections According to the Surgical Level. Glob. Spine J.","DOI":"10.1177\/2192568220988504"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"634","DOI":"10.1007\/s00586-011-1931-2","article-title":"Sagittal spino-pelvic alignment in chronic low back pain","volume":"20","author":"Paquet","year":"2011","journal-title":"Eur. Spine J."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"907","DOI":"10.1007\/s00198-012-2038-2","article-title":"Associations of vertebral deformities and osteoarthritis with back pain among Japanese women: The Hizen-Oshima study","volume":"24","author":"Kitahara","year":"2013","journal-title":"Osteoporos. Int."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"815","DOI":"10.1302\/0301-620X.94B6.28368","article-title":"Percutaneous vertebroplasty for subacute and chronic painful osteoporotic vertebral compression fractures can safely be undertaken in the first year after the onset of symptoms","volume":"94","author":"Nieuwenhuijse","year":"2012","journal-title":"J. Bone Joint Surg. Br."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"k1551","DOI":"10.1136\/bmj.k1551","article-title":"Vertebroplasty versus sham procedure for painful acute osteoporotic vertebral compression fractures (VERTOS IV): Randomised sham controlled clinical trial","volume":"361","author":"Firanescu","year":"2018","journal-title":"BMJ"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1097\/BRS.0000000000002769","article-title":"Balloon Kyphoplasty Versus Conservative Treatment for Acute Osteoporotic Vertebral Fractures With Poor Prognostic Factors: Propensity Score Matched Analysis Using Data From Two Prospective Multicenter Studies","volume":"44","author":"Hoshino","year":"2019","journal-title":"Spine"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1408","DOI":"10.1016\/S0140-6736(16)31341-1","article-title":"Safety and efficacy of vertebroplasty for acute painful osteoporotic fractures (VAPOUR): A multicentre, randomised, double-blind, placebo-controlled trial","volume":"388","author":"Clark","year":"2016","journal-title":"Lancet"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1016\/j.jocn.2013.05.017","article-title":"Percutaneous vertebroplasty compared with conservative treatment in patients with chronic painful osteoporotic spinal fractures","volume":"21","author":"Chen","year":"2014","journal-title":"J. Clin. Neurosci."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Carli, D.F.M., Venmans, A., Lodder, P., Donga, E., van Oudheusden, T., Boukrab, I., Schoemaker, M.C., Smeets, A.J., Schonenberg, C., and Hirsch, J.A. (2020). Vertebroplasty Versus Sham Intervention for Painful Chronic Osteoporotic Vertebral Compression Fractures (VERTOS 5): Randomised Sham Controlled Clinical Trial. SSRN Electron. J.","DOI":"10.2139\/ssrn.3712918"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"895","DOI":"10.1097\/BRS.0000000000003413","article-title":"Risk Factors of Nonunion After Acute Osteoporotic Vertebral Fractures: A Prospective Multicenter Cohort Study","volume":"45","author":"Inose","year":"2020","journal-title":"Spine"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1007\/s00774-014-0646-y","article-title":"The effect of teriparatide to alleviate pain and to prevent vertebral collapse after fresh osteoporotic vertebral fracture","volume":"34","author":"Tsuchie","year":"2016","journal-title":"J. Bone Miner. Metab."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Marongiu, G., Contini, A., Cozzi Lepri, A., Donadu, M., Verona, M., and Capone, A. (2020). The Treatment of Acute Diaphyseal Long-bones Fractures with Orthobiologics and Pharmacological Interventions for Bone Healing Enhancement: A Systematic Review of Clinical Evidence. Bioengineering, 7.","DOI":"10.3390\/bioengineering7010022"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1016\/j.jmpt.2006.11.009","article-title":"Reproduction of the lumbar lordosis: A comparison of standing radiographs versus supine magnetic resonance imaging obtained with straightened lower extremities","volume":"30","author":"Andreasen","year":"2007","journal-title":"J. Manip. Physiol Ther."},{"key":"ref_25","first-page":"233","article-title":"Comparison of Lumbar Lordosis in Lateral Radiographs in Standing Position with supine MR Imaging in consideration of the Sacral Slope","volume":"189","author":"Benditz","year":"2017","journal-title":"Rofo"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/6\/1566\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T22:35:31Z","timestamp":1760135731000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/6\/1566"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3,12]]},"references-count":25,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2022,3]]}},"alternative-id":["jcm11061566"],"URL":"https:\/\/doi.org\/10.3390\/jcm11061566","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,3,12]]}}}