Zhanwei Wang, Jianjie Wang, Chen Jin, Xuqiang Zhan, Yi Li, Qingzhi Xiang, Kaiwei Wang, Haofei Ni, Tao Dai, Yan Yu, Ning Xie
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引用次数: 0
Abstract
Background: Pseudarthrosis is a common complication of transforaminal lumbar interbody fusion (TLIF) that can affect the long-term prognosis and increase revision surgery risk. Therefore, it is crucial to investigate the risk factors associated with pseudarthrosis and develop a predictive model.
Methods: Patients who underwent TLIF at a single hospital between January 2019 and June 2021 were included. Each patient's fusion status was determined based on thin-section lumbar spine CT scans performed at least one year postoperatively. A nomogram was subsequently established to predict the probability of pseudarthrosis based on the results of least absolute shrinkage and selection operator (LASSO) and multivariable analysis. Receiver operating characteristic curve (ROC), calibration curve, and decision curve analysis (DCA) were applied to evaluate the prediction effect and clinical value of the model.
Results: In total, 284 patients (131 men [46.1 %]; mean [standard deviation, SD] age, 63.0[12.1] years) were included in the analysis (mean [SD] follow-up, 19.2[9.2] months). The incidence of pseudarthrosis was 13.4% (38/284). In LASSO and multivariable analysis, independent risk factors for pseudarthrosis included: history of smoking (odds ratio [OR]:2.966, 95% confidence interval [CI]: 1.135-7.750, P=0.027), osteoporosis (OR=6.362, 95% CI: 2.433-16.636, P<0.001), and the change of mean disc height (ΔMDH) (OR=2.401, 95% CI: 1.638-3.519, P<0.001). The areas under the curves (AUC) in the training and validation cohorts were 0.870 and 0.809, respectively.
Conclusions: History of smoking, osteoporosis, and ΔMDH are all independent risk factors of pseudarthrosis following TLIF surgery; a nomogram based on these may help predict the probability of pseudarthrosis.
期刊介绍：
Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance.
Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
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