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腰椎间盘自噬强度及Charlson合并症指数对单节段腰椎间盘突出症患者术后疗效的预测指导意义

Guiding significance of the autophagy intensity of lumbar intervertebral discs and the Charlson Comorbidity Index in predicting the postoperative curative effect of patients with single-level lumbar disc herniation.

作者信息

Yao Zhipeng, Lin Taotao, Wu Rongcan, Lin Hailin, Lin Xianfeng, Qin Chao, Shi Tengbin, Ye Xiaoqing, Zhou Linquan, Chen Gang, Wang Zhenyu, Liu Wenge

机构信息

Department of Orthopedics, Fujian Medical University Union Hospital, Fuzhou, 086-350001, China.

Fujian Medical University, Fuzhou, 086-350001, China.

出版信息

Sci Rep. 2025 Jun 4;15(1):19662. doi: 10.1038/s41598-025-03539-x.

Abstract

To explore whether the autophagy intensity of lumbar intervertebral discs or Charlson Comorbidity Index(CCI) can predict the postoperative curative effect of single-level lumbar disc herniation(LDH) in patients. According to age stratification, five patients with single-level LDH who underwent surgical treatment in our hospital were included in each age group, and the autophagy level of the resected lumbar disc was detected by immunohistochemistry. A total of 30 patients were included and followed up for 2 years. According to the JOA improvement rate at the last follow-up, the patients were divided into two groups. According to age stratification, we found that there were significant differences in autophagy intensity and Pfirrmann classification; that is, with older age, the degree of lumbar disc degeneration was more serious and the autophagy intensity was lower. According to the JOA improvement rate, we found that there were significant differences in age, Autophagy intensity, Pfirrmann classification and CCI classification between different groups (P < 0.05). By binary logistic regression analysis, we found that only CCI classification was an independent risk factor for the difference in postoperative improvement in patients with single-level lumbar discectomy, and patients with a CCI ≥ 2 were more likely to have a poor postoperative improvement rate.

摘要

探讨腰椎间盘的自噬强度或查尔森合并症指数(CCI)是否能够预测单节段腰椎间盘突出症(LDH)患者的术后疗效。按照年龄分层,每个年龄组纳入5例在我院接受手术治疗的单节段LDH患者,采用免疫组织化学法检测切除的腰椎间盘的自噬水平。共纳入30例患者并随访2年。根据末次随访时的JOA改善率将患者分为两组。按照年龄分层,我们发现自噬强度和Pfirrmann分级存在显著差异;即随着年龄增长,腰椎间盘退变程度越严重,自噬强度越低。根据JOA改善率,我们发现不同组之间在年龄、自噬强度、Pfirrmann分级和CCI分级方面存在显著差异(P<0.05)。通过二元逻辑回归分析,我们发现仅CCI分级是单节段腰椎间盘切除术患者术后改善差异的独立危险因素,且CCI≥2的患者术后改善率较差的可能性更大。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8a92/12137810/60a8d15eb8cc/41598_2025_3539_Fig1_HTML.jpg

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