Xiao Jing, Deng Gaoyong, Ling He, Li Wencai
Dept. Neurosurgery, The Affiliated Hospital of Guilin Medical University, Guilin, 541001, Guangxi, China.
Dept. Orthopedics Trauma and Hand Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.
Sci Rep. 2025 Mar 14;15(1):8901. doi: 10.1038/s41598-025-93703-0.
This study aims to construct a nomogram to predict the prognosis of patients with cervical spondylotic myelopathy (CSM). This study included 358 patients diagnosed with cervical spondylotic myelopathy. We collected serological indicators of patients at admission, including routine blood tests, biochemical tests, liver and kidney function, coagulation function and other laboratory tests. We used t-test, rank-sum test, chi-square test or Fisher test for inter-group comparison. We used univariate and multivariate logistic regression analysis to obtain independent predictors of poor prognosis of patients, and constructed the independent predictors into a nomogram using R language, and verified the predictive performance of the nomogram. The results showed that Platelets (PLT) (1.005 [1.001, 1.009], p = 0.021), Albumin (ALB) (0.891 [0.818, 0.97], p = 0.008), Aspartate aminotransferase (AST) (1.031 [1.002, 1.061], p = 0.035), Alanine aminotransferase (ALT) (0.958 [0.92, 0.998], p = 0.037), and Fibrinogen (FIB) (0.654 [0.464, 0.921], p = 0.015) were independent predictors. Good prediction performance with modest errors was shown by the nomogram in both the training and validation groups. ALB, AST, ALT, FIB, and PLT at admission may be independent predictors of the efficacy of ACDF in CSM patients. The nomogram constructed with these factors has good predictive performance. Serological indicators can be used as a supplement to cervical spine-related imaging indicators, allowing clinicians to better complete the admission diagnosis and treatment process and preoperative evaluation process, so that more postoperative patients can benefit.
本研究旨在构建一种列线图以预测脊髓型颈椎病（CSM）患者的预后。本研究纳入了358例被诊断为脊髓型颈椎病的患者。我们收集了患者入院时的血清学指标，包括血常规、生化检查、肝肾功能、凝血功能及其他实验室检查。我们采用t检验、秩和检验、卡方检验或Fisher检验进行组间比较。我们使用单因素和多因素逻辑回归分析来获得患者预后不良的独立预测因素，并使用R语言将这些独立预测因素构建成列线图，并验证列线图的预测性能。结果显示，血小板（PLT）（1.005[1.001,1.009]，p = 0.021）、白蛋白（ALB）（0.891[0.818,0.97]，p = 0.008）、天冬氨酸转氨酶（AST）（1.031[1.002,1.061]，p = 0.035）、丙氨酸转氨酶（ALT）（0.958[0.92,0.998]，p = 0.037）和纤维蛋白原（FIB）（0.654[0.464,0.921]，p = 0.015）是独立预测因素。列线图在训练组和验证组中均显示出具有适度误差的良好预测性能。入院时的ALB、AST、ALT、FIB和PLT可能是CSM患者ACDF疗效的独立预测因素。用这些因素构建的列线图具有良好的预测性能。血清学指标可作为颈椎相关影像学指标的补充，使临床医生能够更好地完成入院诊断和治疗过程以及术前评估过程，从而使更多术后患者受益。
