Effect of gender on the evolution of pain and quality of life after treatment of symptomatic vertebral fragility fractures.

Abstract

Summary: The evolution of pain and quality of life after a symptomatic vertebral fracture difers according to patient gender, with a worse evolution in women independently of the treatment received. Purpose In a previous randomized clinical study comparing the efect of vertebroplasty (VP) vs. conservative therapy (CT) on pain evolution and quality of life (QoL) of patients with symptomatic vertebral fractures (VF), we observed the development of chronic back pain in 23% of subjects, independently of the therapy received. This study analyses the efect of gender on the evolution of pain and QoL in these subjects. Methods: 118/125 randomized patients (27 males/91 females) with recent symptomatic VFs were evaluated. All received a standardized analgesic and antiosteoporotic format of treatment. Pain and QoL were evaluated by VAS and Qualefo-41, respectively, at baseline, at 2 weeks and 2 and 6 months. We compared pain evolution and QoL after treatment (CT vs. VP) according to gender, and analysed factors including age, time of evolution, treatment received, baseline VAS, previous VFs (total and recent), incidental VFs, lumbar and femoral T-scores, and analgesic and antiosteoporotic treatment. Results: At baseline, there were no diferences in age (males 74.8±11.2 vs. females:73.2±8.7 years), time of evolution, number of VFs (males:3.8±2.4 vs. females: 3.1±2.4), treatment received (VP, males:59%, females:45%), lumbar or femoral T-score, baseline VAS (males:6.8±2.1 vs. females:6.8±2.2) or Qualefo score (males:52.2±24.4 vs. females:59.7±20.6). Pain and QoL evolution difered according to gender, being better in males. These diferences were signifcant after two months independently of the treatment and the development of incidental VF during follow-up. Conclusions: Pain and QoL evolution after a symptomatic VF difers according to gender, with a worse evolution in women independently of the treatment received.