Yu Bo, Jiao Jianbao, Li Congjie, Sun Shaosong, Wang Jing, Zhang Chaohui, Liu Teng
Surgical Operating Room, Affiliated Hospital of Hebei University No. 212, Yuhua East Road, Lianchi District, Baoding 071000, Hebei, China.
Department of Orthopedics, Affiliated Hospital of Hebei University No. 212, Yuhua East Road, Lianchi District, Baoding 071000, Hebei, China.
Am J Transl Res. 2023 Feb 15;15(2):1168-1176. eCollection 2023.
To analyze the factors influencing efficacy of spinal fusion for the improvement of degenerative scoliosis in elderly patients.
Retrospective analysis of clinical data was conducted on 194 elderly patients with degenerative scoliosis treated with minimally invasive lumbar lateral fusion at Affiliated Hospital of Hebei University on February 2018 to February 2021. The patients were divided into a recovered group (n = 138) and an uncured group (n = 56) according to their recovery. The basic information of patients, preoperative complications, preoperative and postoperative imaging results, clinical function scores, postoperative complications, and other relevant information were collected. Logistic regression analysis was used to analyze the factors affecting outcome. Receiver operating characteristic curves were used to determine the predictive value of factors influencing prognosis.
Univariate analysis showed that, compared to the uncured group, the recovered group showed younger age, shorter duration of symptoms and length of hospital stay, less history of hypertension or diabetes, and lower Oswestry disability index (ODI), and Japanese Orthopedic Association scores (P<0.05). Multivariate retrospective analysis revealed that age, duration of symptoms, length of hospital stay, history of hypertension and pretreatment ODI score were independent risk factors affecting treatment efficacy (P<0.05). The area under the curve of the risk model for predicting efficacy was 0.951.
Age, duration of symptoms, length of hospital stay, history of hypertension, and pretreatment ODI score are risk factors affecting the treatment outcome of elderly patients with degenerative scoliosis, so these preoperative indications may be indicators to predict efficacy.
分析影响老年退行性脊柱侧凸患者脊柱融合术改善疗效的因素。
回顾性分析2018年2月至2021年2月在河北大学附属医院接受微创腰椎外侧融合术治疗的194例老年退行性脊柱侧凸患者的临床资料。根据恢复情况将患者分为恢复组（n = 138）和未治愈组（n = 56）。收集患者的基本信息、术前并发症、术前和术后影像学结果、临床功能评分、术后并发症及其他相关信息。采用Logistic回归分析影响疗效的因素。绘制受试者工作特征曲线以确定影响预后因素的预测价值。
单因素分析显示，与未治愈组相比，恢复组年龄较小、症状持续时间和住院时间较短、高血压或糖尿病病史较少，Oswestry功能障碍指数（ODI）和日本骨科协会评分较低（P<0.05）。多因素回顾性分析显示，年龄、症状持续时间、住院时间、高血压病史和术前ODI评分是影响治疗效果的独立危险因素（P<0.05）。预测疗效风险模型的曲线下面积为0.951。
年龄、症状持续时间、住院时间、高血压病史和术前ODI评分是影响老年退行性脊柱侧凸患者治疗效果的危险因素，因此这些术前指标可能是预测疗效的指标。
