دورية أكاديمية
أعرض في EDS

Prediction Model and Risk Factor Analysis of Adjacent Segment Disease After L4-5 Transforaminal Lumbar Interbody Fusion Through Preoperative Radiographic Features.

التفاصيل البيبلوغرافية
العنوان: Prediction Model and Risk Factor Analysis of Adjacent Segment Disease After L4-5 Transforaminal Lumbar Interbody Fusion Through Preoperative Radiographic Features.
المؤلفون: Zhang ZJ; School of Medicine, Southeast University, Nanjing, Jiangsu, China., Chen L; Department of Spine Surgery, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, China., Zhu L; Department of Spine Surgery, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, China., Shi H; Department of Spine Surgery, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, China., Zhang FY; School of Medicine, Southeast University, Nanjing, Jiangsu, China., Jiang ZL; Department of Spine Surgery, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, China., Wu XT; Department of Spine Surgery, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, China.
المصدر: Global spine journal [Global Spine J] 2024 Feb 06, pp. 21925682241231764. Date of Electronic Publication: 2024 Feb 06.
Publication Model: Ahead of Print
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: SAGE Publications Country of Publication: England NLM ID: 101596156 Publication Model: Print-Electronic Cited Medium: Print ISSN: 2192-5682 (Print) Linking ISSN: 21925682 NLM ISO Abbreviation: Global Spine J
أسماء مطبوعة: Publication: 2017- : London : SAGE Publications
Original Publication: New York, NY : Thieme Medical Publishers
مستخلص: Study Design: A retrospective study.
Objective: To investigate the risk of adjacent segment disease (ASD) after L4-5 transforaminal lumbar interbody fusion (TLIF) in patients diagnosed with lumbar spinal stenosis (LSS), a prediction model for ASD is established and validated.
Methods: A retrospective study was carried out on a sample of 290 patients who underwent L4-5 TLIF at Zhongda Hospital, Southeast University, from January 2015 to January 2021. The study collected baseline data and preoperative radiographic features of L3-4 and L5-S1. The determination of the outcome variable was based on X-ray results spanning over 24 months and JOA scores. Multivariate logistic regression was used to identify the risk factors in constructing a nomogram.
Results: Independent risk factors for L3-4 degeneration after TLIF included osteoarthritis of L3-4 facet joints, L3-4 foraminal stenosis, L4 upper endplate osteochondritis, L3-4 local lordosis angle, and L3-4 spinal stenosis. Independent risk factors for L5-S1 degeneration after TLIF included osteoarthritis of L5-S1 facet joints, L5-S1 intervertebral disc degeneration, L5-S1 spinal stenosis, L5-S1 coronal imbalance, and S1 upper endplate osteochondritis. A predictive model was developed. The AUC for the prediction models at L3-4 and L5-S1 were .945 and .956. The calibration curve demonstrated good consistency between the predicted and actual probabilities. The DCA curve indicated the clinical benefit and practical value of this predictive model.
Conclusion: This study established nomograms for postoperative degeneration at L3-4 and L5-S1 based on selected preoperative radiographic features. These models provide a valuable auxiliary decision-making system for clinicians and aid in early surgical decisions.
Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
فهرسة مساهمة: Keywords: adjacent segment disease; nomogram; predictive model; transforaminal lumbar interbody fusion
تواريخ الأحداث: Date Created: 20240206 Latest Revision: 20240206
رمز التحديث: 20240207
DOI: 10.1177/21925682241231764
PMID: 38321379
قاعدة البيانات: MEDLINE
الوصف
تدمد:2192-5682
DOI:10.1177/21925682241231764