Construction and validation of a surgical prognostic model for ACDF using zero-profile cage:a retrospective study based on cervical spine dislocation parameters
Objective To analyze the independent risk factors affecting the prognosis of anterior cervical discectomy and fusion(ACDF)with zero-profile cage using LASSO-logistic regression and to establish a prognostic prediction model.Methods A total of 297 patients who underwent ACDF for cervical spondylotic myelopathy from February 2017 to February 2023 in Department of Neurosurgery,the First Hospital of Shanxi Medical University and Yuncheng Central Hospital with complete follow-up data was included retrospectively.The potential risk factors and determine independent risk factors for poor postoperative prognosis were screened out.Prediction models for poor prognosis were constructed and validated.Results The rate of good prognosis was 90.24％.Bi nary logistic regression analysis identified age as an independent risk factor for poor prognosis(OR=1.164,P＜0.001,95％CI=1.067-1.270),preoperative neck disability index(NDI,OR=1.245,P＜0.001,95％CI=1.118-1.387),T2WI hyperintensity(OR=11.611,P＜0.001,95％CI=2.989-45.106),postoperative cervical lordosis(CL,OR=0.751,P＜0.001,95％CI=0.642-0.878)and postoperative T,slope(T1S,OR=1.203,P=0.001,95％CI=1.051-1.378).Receiver operating characteristic(ROC)curve analysis showed that the nomogram showed good predictive value and effectiveness.Conclusions Age,T2WI hyperintensity,preoperative NDI,postoperative T1 S,and postoperative CL are independent risk factors affecting the prognosis of patients after ACDF using zero-profile cages,and nomograms constructed using risk factors reflect good predictive value and effectiveness.
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