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Ⅰ度退行性腰椎滑脱症的危险因素分析及预测模型

Risk factors analysis and predictive model of degree I degenerative lumbar spondylolisthesis.

作者信息

Wang RuiYang, Ru Neng, Liu Qing, Zhang Fan, Wu Yu, Guo ChangJin, Liang Jie

机构信息

Orthopedics Department, The First College of Clinical Medical Science, China Three Gorges University, Yichang, China.

出版信息

J Orthop Surg Res. 2024 Dec 18;19(1):831. doi: 10.1186/s13018-024-05346-y.

Abstract

STUDY DESIGN

Retrospective Case-Control Study.

BACKGROUND

There have been some previous studies on the risk factors associated with lumbar spondylolisthesis, but there are few studies on the risk factors for disease progression in mild degenerative lumbar spondylolisthesis (DLS). To analyze the risk factors associated with aggravation of spondylolisthesis in patients with grade I degenerative spondylolisthesis and construct a prediction model.

METHODS

We conducted a retrospective analysis of 220 patients diagnosed with DLS who were admitted to our hospital between January 2019 and January 2023. Data collected included gender, age, body mass index (BMI), diabetes, hypertension, occupation, and imaging parameters.

RESULTS

A total of 220 patients were included in this study, including 111 males and 109 females; 178 patients with no aggravation of lumbar spondylolisthesis (group A) and 42 patients with aggravation of lumbar spondylolisthesis (group B). Progression of grade I DLS was associated with single factors such as age, BMI, Occupation, vertebral CT value, facet joint angle (FJA), Modic change (MC), Pfirrmann grade of intervertebral disc (PG), Facet joint effusion (FJE), osteophyte formation, and Percentage of the Fat Infiltration (FIA%) of multifidus muscle (MM). BMI, FJA, PG, and FI% of MM had a significant impact on disease progression in lumbar spondylolisthesis.

CONCLUSION

BMI, FJA, PG, and FIA% of MM were independent risk factors for the progression of degenerative spondylolisthesis. The risk prediction model was established by including the above four variables and nomograms were drawn. The internal validation proved that the model had good discrimination, calibration, and clinical practicability.

摘要

研究设计

回顾性病例对照研究。

背景

既往有一些关于腰椎滑脱相关危险因素的研究,但针对轻度退行性腰椎滑脱(DLS)疾病进展的危险因素研究较少。旨在分析Ⅰ度退行性腰椎滑脱患者腰椎滑脱加重的相关危险因素并构建预测模型。

方法

对2019年1月至2023年1月期间我院收治的220例诊断为DLS的患者进行回顾性分析。收集的数据包括性别、年龄、体重指数(BMI)、糖尿病、高血压、职业以及影像学参数。

结果

本研究共纳入220例患者,其中男性111例,女性109例;腰椎滑脱无加重患者178例(A组),腰椎滑脱加重患者42例(B组)。Ⅰ度DLS进展与年龄、BMI、职业、椎体CT值、小关节角(FJA)、Modic改变(MC)、椎间盘Pfirrmann分级(PG)、小关节积液(FJE)、骨赘形成以及多裂肌(MM)脂肪浸润百分比(FIA%)等单因素有关。BMI、FJA、PG以及MM的FI%对腰椎滑脱疾病进展有显著影响。

结论

BMI、FJA、PG以及MM的FIA%是退行性腰椎滑脱进展的独立危险因素。纳入上述四个变量建立了风险预测模型并绘制了列线图。内部验证证明该模型具有良好的区分度、校准度和临床实用性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/86b0/11657725/687cb5400c5d/13018_2024_5346_Fig1_HTML.jpg

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