Reason analysis and treatment of postoperative lumbar pain after vena cava filter placement

Objective To investigate the causes of low back pain after implantation of inferior vena cava (IVC) filter and summarize the clinical therapeutic effect. Methods The clinical data of 339 patients with IVC filter implantation in the third Hospital of Hebei Medical University were analyzed retrospectively. According to the types of implanted filters, the patients were divided into permanent filter group (153 cases) and recovery filter group (186 cases). All the patients underwent IVC angiography after filter implantation. According to the abnormal IVC, both the permanent filter group and the recovery filter group were divided into two subgroups: (1) abnormal IVC group (28 cases); (2) normal IVC group (permanent normal subgroup, 125 cases); (3)abnormal IVC group (recovery subgroup, 46 cases); (4) normal IVC group (140 cases). The items of the incidence of low back pain, the degree of low back pain and the abnormal condition of ICV angiography in each groups and subgroups were observed and recorded, as well as the degree of low back pain and the therapeutic effect between the two groups were analyzed and compared. Result (1) Incidence of low back pain: The incidence of low back pain in the recovery filter group was higher than that in the permanent filter group with the difference was statistically significant (10.22% vs 2.61%, P<0.05). The incidence of low back pain in the permanent abnormal subgroup was higher than that in the permanent normal subgroup (10.71% vs 0.80, P<0.05). For the incidence of low back pain, the abnormal recovery subgroup was higher than that in the normal recovery subgroup (34.78% vs 2.14 P<0.05), and the abnormal recovery subgroup was higher than that in the permanent abnormal subgroup (34.78% vs 2.14%, P<0.05). The incidence of low back pain in the abnormal recovery subgroup was higher than that in the permanent abnormal subgroup (34.78% vs 10.71%, P<0.05). (2)The degree of low back pain in the permanent filter group was higher than that in the control group(P <0.05). In the recovery filter group, there were 19 cases with low back pain: 15 cases were grade Ⅰ, in which 13 cases were relieved spontaneously, and the remaining 2 cases were relieved by oral analgesics; 3 cases were Ⅱ degree, in which 2 cases were relieved after injection of analgesics, and the other case was relieved after removal of filter; One case was degree Ⅲ, who was relieved by injection of analgesics until the filter was removed. Conclusion The reason of low back pain caused by implantation of inferior vena cava filter is related to the injury of vessel wall by the filter. Moreover, the degree of lumbago is mainly in degree I, most of which can be tolerated and self-relieved, or else analgesics can be used. Key words: Inferior vena cava filter; Placement; Complication; Lumbago; Treatment outcome