title: Is severe pain immediately after spinal augmentation a predictor of long-term outcomes?
abstract: OBJECTIVE
  Severe, immediate postprocedural pain and the need for analgesics after vertebroplasty can be a discouraging experience for patients and caregivers. The goal of this study was to investigate whether the presence of severe pain immediately after vertebroplasty predicts short- and long-term pain relief.
  
  
  METHODS
  A chart review was performed to categorize patients regarding pain severity and analgesic usage immediately after vertebroplasty (< 4 h). "Severe" pain was defined as at least 8 of 10 with the 10-point VAS. Outcomes were pain severity and pain medication score and usage at 1 month and 1 year after vertebroplasty. Outcomes and clinical characteristics were compared between groups by using the Wilcoxon signed-rank test and the Fisher exact test.
  
  
  RESULTS
  Of the 429 vertebroplasty procedures identified, 69 (16%) were associated with severe pain, and 133 (31%) were associated with analgesic administration immediately after the procedure. The group experiencing severe pain had higher preprocedure median VAS rest pain scores (5 [IQR, 2-7]) and activity pain scores (10 [IQR, 8-10]) compared with patients who did not experience severe pain (3 [IQR, 1-6]; P = .0208, and 8 [IQR, 7-10]; P = .0263, respectively). At 1 month postprocedure, VAS rest and activity pain scores were similar between the severe pain group and the nonsevere pain group (P = .16 and P = .25, respectively) and between the group receiving pain medication and the group not receiving pain medication (P = .25 and P = .67, respectively). This similarity continued for 1 year after the procedure. Analgesic usage was similar among all groups at 1 year postprocedure.
  
  
  CONCLUSIONS
  Patients with severe pain immediately after vertebroplasty have similar long-term outcomes compared with patients without severe pain.
authors.affiliation: Departments of Radiology.
authors.forename: Y W
authors.initials: YW
authors.lastname: Cho
authors.forename: J S
authors.initials: JS
authors.lastname: McDonald
authors.forename: A E
authors.initials: AE
authors.lastname: Rad
authors.forename: J J
authors.initials: JJ
authors.lastname: Ocel
authors.forename: D F
authors.initials: DF
authors.lastname: Kallmes
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015984:Causality; D059350:Chronic Pain / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control*; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D008910:Minnesota / Q000453:epidemiology; D010147:Pain Measurement / Q000706:statistics & numerical data*; D010149:Postoperative Pain / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control; D015995:Prevalence; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D016103:Spinal Fractures / Q000453:epidemiology* / Q000628:therapy*; D016896:Treatment Outcome; D054854:Vertebroplasty / Q000706:statistics & numerical data*