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目的:探讨经皮椎体成形术（percutaneous vertebroplasty，PVP）术后早期（术后1个月内）患者腰背部残余疼痛的危险因素，并进一步分析其相关性。方法:回顾性分析2013年3月至2015年1月期间采用PVP治疗的1 316例骨质疏松性椎体压缩性骨折（osteoporotic vertebral compression fractures，OVCF）患者的相关资料。术后1周及1个月评估疼痛视觉模拟评分（visual analogue scale，VAS），VAS评分> 4分定义为PVP术后腰背部疼痛缓解不佳。根据疼痛缓解情况，将患者分为满意组和不满意组。所有患者在术后1周，1、3个月和1年进行随访，行X线和MR检查（T1加权像、T2加权像和压脂像）排除新发OVCF，并同时记录VAS评分和Oswestry功能障碍指数（Oswestry disability index，ODI）。统计两组患者的人口统计学资料、手术相关信息、麻醉方式、OVCF数量、单椎体骨水泥注射量、影像学数据和其他合并症信息，采用Logistic回归分析其与PVP术后腰背部残余疼痛的相关因素。结果:接受PVP治疗的1 316例胸、腰椎OVCF患者中60例（4.6%）患者术后腰背部疼痛缓解不佳。两组患者VAS评分和ODI在术后1周、1个月、3个月时的差异有统计学意义，提示不满意组患者腰背部存在一定程度的残余疼痛，其程度重于满意组，但在术后12个月随访时差异无统计学意义。单因素分析结果显示，术前骨密度、骨折椎体数量、骨水泥分布情况、单椎体骨水泥注射量及腰背筋膜损伤与术后腰背部疼痛缓解不佳有关（均n P< 0.01）。多因素Logistic回归分析结果显示术前骨密度（n OR=3.577，n P=0.029）、合并腰背筋膜损伤（n OR=3.805，n P=0.002)、骨折椎体数量（n OR=3.440，n P< 0.001）、骨水泥分布情况（n OR=3.009，n P=0.013）和合并抑郁症（n OR=3.426，n P=0.028）与PVP术后腰背部疼痛缓解不佳存在正相关，是其危险因素；单椎体骨水泥注入量（n OR=0.079，n P 4 both 1 week and 1 month post-operatively. According to the pain relief, the patients were divided into two groups, the satisfied group and the unsatisfied group. All patients were scheduled for follow-up at1 week, 1 month, 3 months, and 1 year post-operatively, during which radiography and magnetic resonance imaging (T1-weighted, T2-weighted, and short time inversion recovery (STIR) sequences) were recommended to detect the existence of secondary OVCF. VAS scores and Oswestry disability index (ODI) were recorded. Demographic data, surgical information, anesthesia method, number of OVCF, injection amount of cement of single vertebral bone, imaging data and other comorbidity informations of patients in the two groups were analyzed by Logistic regression for the factors related to RBP after PVP.Results:Among 1 316 patients, 60 cases complained RBP, and the prevalence was 4.6%. VAS score and ODI of the two groups were significantly different at 1 week, 1 month and 3 months after surgery, suggesting there was a certain degree of residual pain in the lower back of patients in the unsatisfied group, which was more severe than that in the satisfied group. However, the above differences disappeared in the follow-up of 12 months after surgery.Univariate analysesshowed that preoperative bone mineral density (BMD), number of fracture, cement distribution and volume injected per level and lumbodorsal fascia contusion were associated with RBP after PVP (n P< 0.01, retrospectively). Multivariate analysis revealed that the absolute value of pre-operative BMD(odds ratio (n OR)=3.577, n P=0.029), combined withlumbodorsal fascia contusion (n OR=3.805, n P=0.002), number of fracture (n OR=3.440, n P<0.001), satisfactory cement distribution (n OR=3.009, n P=0.013) and combined with depression (n OR=3.426, n P=0.028) were positively correlated with RBP after PVP, and these were risk factors. The injection amount of cement of single vertebral bone (n OR=0.079, n P<0.001) was negatively correlated with RBP after PVP, which was a protective factor.n Conclusion:Pre-operative low BMD, lumbodorsal fascial injury, multiple segment OVCF, insufficient cement injected volume, unsatisfactory cement distribution and depression were risk factors associated with RBP after PVP in patients with OVCF.