Protection motivation theory-based management after surgery for osteoporotic vertebral fractures: Modulating inflammatory factors and pain mediators, and ameliorating hypercoagulability and bone metabolism

The purpose of this research was to investigate how the protection motivation theory (PMT)-based management model influences inflammatory factors, pain mediators, coagulation function, and bone metabolism in postsurgical osteoporotic vertebral fracture (OVF) patients. Between February 2024 and March 2025, OVF patients undergoing surgery at our center were recruited for this investigation. Ultimately, 74 patients were assigned to the PMT group, compared with 71 who were designated as controls. For each participant, venous blood sampling under fasting conditions was performed preoperatively and on postoperative day 5. We then measured a comprehensive set of parameters using dedicated techniques: inflammatory factors (interleukin-1 beta [IL-1β], interleukin-6, interleukin-10 [IL-10], tumor necrosis factor-α, high-sensitivity C-reactive protein [hs-CRP]) and bone metabolism markers (C-terminal telopeptide of type I collagen [CTX], bone Gla protein [BGP], osteocalcin [OC]) via enzyme-linked immunosorbent assay, pain mediators (substance P [SP], prostaglandin E2 [PGE2]) via radioimmunoassay, oxidative stress markers (malondialdehyde [MDA], superoxide dismutase) via the thiobarbituric acid method, and coagulation parameters (D-dimer [D-D], fibrinogen [FIB], P-selectin, platelet) via an automatic coagulation analyzer. The resulting data were subjected to both intragroup and intergroup comparative analyses. In addition, the adverse reactions during the perioperative period were counted, and the Japanese Orthopaedic Association (JOA) scores and Barthel index (BI) questionnaires were conducted before and 1 month after the operation to evaluate the rehabilitation quality of the patients. Surgical intervention resulted in an increase in IL-1β, interleukin-6, tumor necrosis factor-α, hs-CRP, SP, PGE2, MDA, D-D, FIB, P-selectin, and CTX, as well as a decrease in IL-10, superoxide dismutase, BGP, and OC in both cohorts (P < .05). According to intergroup analyses, the PMT group exhibited lower IL-1β, hs-CRP, SP, PGE2, MDA, D-D, FIB, and CTX, along with higher IL-10, platelet, BGP, and OC, than controls (P < .05). The incidence of perioperative deep vein thrombosis in the PMT group was lower than that in the control group (P < .05). Although the JOA and BI of the 2 groups were higher than those before operation, the JOA and BI of the PMT group were higher than those of the control group at 1 month after operation (P < .05). Early postoperative adoption of PMT-based management following OVF surgery contributes to significant clinical improvements by suppressing systemic inflammation, limiting pain mediator synthesis, ameliorating hypercoagulability, and normalizing disrupted bone metabolism.