Analysis of the risk factors for degenerative lumbar spondylolisthesis based on lumbar sagittal and axial MRI parameters and construction of prediction model
Analysis of the risk factors for degenerative lumbar spondylolisthesis based on lumbar sagittal and axial MRI parameters and construction of prediction model
Objective To analyze the risk factors for degenerative lumbar spondylolisthesis(DLS)based on lumbar sagittal and axial MRI parameters,and to construct a prediction model.Methods Seventy patients with DLS(DLS group)and 140 patients with-out degenerative diseases like lumbar spondylolisthesis(non-DLS group)who were admitted to the hospital from January 2021 to Sep-tember 2023 were selected.All patients received lumbar sagittal and axial MRI scanning.MRI parameters(lumbar disc degeneration grade,facet joint degeneration grade,endplate Modic modification of classification and lumbosacral Angle,thickness of ligamentum fla-vum,width of facet joint effusion)were compared between the two groups.Ordinal logistic regression analysis was conducted to screen the influencing factors of DLS,and a prediction model for DLS was constructed based on these factors.The predictive performance of the prediction model was evaluated with the receiver operating characteristic curve(ROC).Results Compared with non-DLS group,the proportion of long-term excessive weight bearing,grade of lumbar disc degeneration,grade of facet joint degeneration,class of Modic changes,umbosacral angle,and width of facet joint effusion in DLS group were higher/larger(P＜0.05).Logistic regression analysis found that the grade of lumbar disc degeneration higher than grade Ⅲ(OR=13.730,95％CI:2.388-78.952),the grade of facet joint degeneration higher than grade I(OR=11.025,95％CI:1.752-69.365),Modic changes higher than class Ⅰ(OR=7.386,95％CI:1.063-51.319),lumbosacral angle larger than 45°(OR=17.127,95％CI:2.805-104.565)and width of facet joint effu-sion greater than 1.4 mm(OR=47.567,95％CI:2.858-791.612)were independent risk factors for DLS(P＜0.05).No long-term excessive weight bearing was a protective factor(OR=0.082,95％CI:0.009-0.758,P＜0.05).A prediction model was con-structed based on above-mentioned factors,and the expression was as follow:Logit P=-8.339-2.507 × no long-term excessive weight bearing+2.620 × grade of lumbar disc degeneration+2.400 × grade of facet joint degeneration+2.000 × Modic changes classi-fication+2.841 × lumbosacral angle+3.862 × width of facet joint effusion.Hosmer Lemeshow test showed a high degree of fitting(P=0.667).The area under the curve,sensitivity and specificity of the prediction model were 0.980,94.29％and 95.79％(95％CI:0.961-0.999).Conclusions The lumbar sagittal and axial MRI parameters(grade of lumbar disc degeneration,grade of facet joint degeneration,classification of Modic changes,lumbosacral angle,width of facet joint effusion and excessive weight bearing time)are closely related to DLS.The prediction model constructed based on the influencing factors has good predictive performance and can pro-vide reference for clinical practice.
关键词
退行性腰椎滑脱/磁共振成像/风险因素/预测模型
Key words
degenerative lumbar spondylolisthesis/magnetic resonance imaging/risk factor/prediction model
维普
万方数据