胸腰椎损伤分类与严重度评分联合载荷分享评分对胸腰椎椎体骨折微创手术治疗患者近期预后的评价研究  被引量:5

Evaluation of short-term prognosis of thoracolumbar vertebral fracture treated by minimally invasive surgery with thoracolumbar injury classification and severity score combined with load sharing classification

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作  者:逯登鹏 尚大财 尚晋 LU Deng-peng;SHANG Da-cai;SHANG Jin(Department of Orthopedics,Renji Hospital,Xi'ning,Qinghai,810021,China)

机构地区:[1]青海仁济医院骨科,西宁810021

出  处:《中国骨与关节杂志》2022年第2期147-151,共5页Chinese Journal of Bone and Joint

基  金:2017年青海省科学技术成果(26335784)。

摘  要:目的探讨胸腰椎损伤分类与严重度评分(thoracolumbar injury classification and severity score,TLICS)联合载荷分享评分(load sharing classification,LSC)对胸腰椎椎体骨折微创手术治疗患者近期预后的评价价值。方法选取2017年8月至2020年3月我院收治的行微创手术治疗的胸腰椎椎体骨折患者149例,术后均随访6个月。根据术后6个月的Oswestry功能障碍指数(oswestry disability index,ODI),将患者分为预后良好者与预后不良者。对比两者术前TLICS、LSC评分,并采用Pearson相关性分析法分析术前TLICS、LSC评分与ODI的关系,另采用受试者工作曲线(receiver operating curve,ROC)评价TLICS+LSC评分对患者近期预后的评估价值。结果本组149例术前ODI平均(74.16±6.85)分,术后6个月平均(24.31±4.26)分,根据术后6个月ODI较术前改善情况,预后不良者21例,预后不良发生率为14.09%(21/149);预后良好者术前TLICS、LSC评分均明显低于预后不良者(P <0.05);经Pearson相关性分析,患者术前TLICS、LSC评分与ODI均呈明显正相关性(P <0.05);根据ROC,术前TLICS、LSC评分单项及联合预测胸腰椎椎体骨折患者微创术后近期预后不良的灵敏度分别为90.48%、85.71%、85.71%,特异度分别为80.47%、81.25%、93.75%,曲线下面积(area under curve,AUC)分别为0.840、0.836、0.956。结论胸腰椎椎体骨折患者TLICS、LSC评分均与ODI相关,且均对患者微创术后的近期预后具有良好的评估价值,但两者联合评估时的价值更高。Objective To investigate the value of thoracolumbar injury classification and severity score (TLICS) combined with load sharing classification (LSC) in the evaluation of short-term prognosis of patients with thoracolumbar vertebral fracture treated by minimally invasive surgery.Methods A series of 149 patients with thoracolumbar vertebral fracture treated by minimally invasive surgery in our hospital from August 2017 to March 2020 was selected,and all patients were followed up for 6 months after surgery.According to the Oswestry disability index (ODI) 6 months after surgery,all patients were divided into good prognosis and poor prognosis group.Preoperative TLICS and LSC were compared between the two groups,and the relationship between preoperative TLICS,LSC and ODI were analyzed by Pearson correlation analysis.The value of TLICS combined with LSC was assessed in the evaluation of the short-term prognosis by receiver operating curve (ROC).Results The average ODI of 149 patients was (74.16±6.85) before surgery and (24.31±4.26) 6 months after operation.There were 21 cases with poor prognosis according to the improvement of ODI 6 months after operation compared with that before operation,and the incidence rate of poor prognosis was 14.09% (21 / 149).Preoperative TLICS and LSC of the good prognosis group were significantly lower than those with poor prognosis (P < 0.05).Pearson correlation analysis showed that the preoperative TLICS,LSC and ODI were positively correlated (P < 0.05).According to ROC,the sensitivity of preoperative TLICS and LSC in single and joint prediction of short-term poor prognosis of thoracolumbar vertebral fracture after minimally invasive surgery was 90.48%,85.71%,85.71%,respectively.The specificity was 80.47%,81.25%,93.75%,respectively,and the area under curve (AUC) was 0.840,0.836,0.956 respectively.Conclusions Both TLICS and LSC are related to ODI in patients with thoracolumbar vertebral fracture,which have good evaluation value for the short-term prognosis of patients after minimally inva

关 键 词:脊柱骨折 研究设计 最小侵入性外科手术 

分 类 号:R683.2[医药卫生—骨科学]

 

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