Objective To explore the factors affecting changes of disc angle(ΔDA)during oblique lateral interbody fu-sion(OLIF)and establish a predictive model of ΔDA.Methods This retrospective study included 119 patients with 174 seg-ments undergoing OLIF procedures between July 2017 and August 2019 in Beijing Jishuitan Hospital.45 males and 74 females with an average age of 62.1±9.8 years(33-86 years)were included.The lordotic cages were all 6 degrees.Radiographic parame-ters included preoperative and postoperative disc angle(DA),disc height(DH),ΔDA on flexion-extension views(ΔDA-FE),cage location and cage inclination.Pearson correlation coefficient and machine-learning techniques were utilized to identify factors re-lated to ΔDA.Based on machine leaning techniques,ten-fold cross-validation for model training and validation were used to devel-op a predictive linear model for ΔDA.Results The average ΔDA was 3.9°±4.8° with preoperative disc angle(preoperative DA)of 5.3°±5.0°.The average change of posterior DH(ΔPDH)was 3.1±2.1 mm with preoperative posterior DH of 6.6±1.9 mm.The av-erage change of anterior DH was 6.1±3.2 mm.Pearson correlation analysis showed a significant negative correlation between ΔDA and preoperative DA(r=-0.713,P＜0.001),cage location(r=-0.183,P=0.016),and ΔDA-FE(r=-0.153,P=0.044).PDH changes were significantly negatively correlated with preoperative PDH(r=-0.444,P＜0.001)and positively correlated with cage location(r=0.218,P=0.004).ΔDA was 10.8°±3.2° for negative preoperative DA(indicating kyphotic),5.0°±3.7° for preoperative DA between 0° and 6°,and 1.0°±4.1° for preoperative DA＞6°.A predictive model was developed using ten-fold cross-validation,resulting in the formula ΔDA=7.9°-0.8 x preoperative DA(R=0.707,MAE=2.837).Conclusion Disc angle changes in OLIF primarily de-pend on the preoperative disc angle,secondly on cage location.The predicting model based on machine-learning techniques using preoperative disc angle facilitates preoperative planning for OLIF procedures.
维普
万方数据