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Background <p>Percutaneous kyphoplasty is a widely used minimally invasive procedure for osteoporotic vertebral compression fractures, effectively alleviating pain and partially restoring vertebral height. However, some patients experience persistent pain postoperatively, making a systematic exploration of the contributing reasons crucial for improving clinical outcomes.</p> Methods <p>Based on relevant literature retrieved from the PubMed database, this review systematically examines the potential causes of unresolved pain after PKP, with a focus on surgical techniques, complications, and patient-specific factors.</p> Results <p>The reasons for unresolved pain after PKP are multifactorial, primarily including: suboptimal bone cement distribution, such as failure to contact both the upper and lower endplates, which is associated with an increased risk of vertebral re-collapse and new adjacent fractures; cement leakage, which remains a common cause of complications and pain despite PKP potentially having a lower leakage rate than percutaneous vertebroplasty; new vertebral fractures postoperatively, with female gender, low bone mineral density, and diabetes being significant risk factors; delayed surgical intervention, as intervention beyond 12 weeks is associated with poorer pain relief; and other factors such as thoracolumbar fascia injury and fracture nonunion are also linked to residual back pain.</p> Conclusion <p>Unresolved pain after PKP is a multifactorial issue involving surgical technique, material properties, and patient condition. Optimizing cement injection technique (e.g., ensuring adequate diffusion to the endplates), timing the surgery appropriately, and enhancing perioperative osteoporosis management may help improve outcomes. Higher-quality studies are needed in the future to validate these risk factors and develop individualized treatment strategies.</p>

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Exploration of Causes for Persistent Pain after Percutaneous Kyphoplasty (PKP) in Osteoporotic Vertebral Compression Fractures(OVCF)

  • 期刊论文

  • 发表日期：

    2026年7月6日

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  • Hua Cao,
  • Liang-Wen Li,
  • Min-gang Yao,
  • Bin Sheng

摘要

Background

Percutaneous kyphoplasty is a widely used minimally invasive procedure for osteoporotic vertebral compression fractures, effectively alleviating pain and partially restoring vertebral height. However, some patients experience persistent pain postoperatively, making a systematic exploration of the contributing reasons crucial for improving clinical outcomes.

Methods

Based on relevant literature retrieved from the PubMed database, this review systematically examines the potential causes of unresolved pain after PKP, with a focus on surgical techniques, complications, and patient-specific factors.

Results

The reasons for unresolved pain after PKP are multifactorial, primarily including: suboptimal bone cement distribution, such as failure to contact both the upper and lower endplates, which is associated with an increased risk of vertebral re-collapse and new adjacent fractures; cement leakage, which remains a common cause of complications and pain despite PKP potentially having a lower leakage rate than percutaneous vertebroplasty; new vertebral fractures postoperatively, with female gender, low bone mineral density, and diabetes being significant risk factors; delayed surgical intervention, as intervention beyond 12 weeks is associated with poorer pain relief; and other factors such as thoracolumbar fascia injury and fracture nonunion are also linked to residual back pain.

Conclusion

Unresolved pain after PKP is a multifactorial issue involving surgical technique, material properties, and patient condition. Optimizing cement injection technique (e.g., ensuring adequate diffusion to the endplates), timing the surgery appropriately, and enhancing perioperative osteoporosis management may help improve outcomes. Higher-quality studies are needed in the future to validate these risk factors and develop individualized treatment strategies.