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A nomogram for predicting screw loosening after single-level posterior lumbar interbody fusion utilizing cortical bone trajectory screw: A minimum 2-year follow-up study

PURPOSE: This study aims to investigate the risk factors for screw loosening after single-level posterior lumbar interbody fusion (PLIF) utilizing cortical bone trajectory (CBT) screw and establish a nomogram for predicting screw loosening. METHODS: A total of 79 patients (316 screws) who underwent...

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Autores principales: Zhang, Yiqi, Li, Yue, Hai, Yong, Guan, Li, Zhang, Xinuo, Pan, Aixing, Lu, Hongyi, Wu, Bingchao, Liu, Yuzeng
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9615560/
https://www.ncbi.nlm.nih.gov/pubmed/36311946
http://dx.doi.org/10.3389/fsurg.2022.950129
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author Zhang, Yiqi
Li, Yue
Hai, Yong
Guan, Li
Zhang, Xinuo
Pan, Aixing
Lu, Hongyi
Wu, Bingchao
Liu, Yuzeng
author_facet Zhang, Yiqi
Li, Yue
Hai, Yong
Guan, Li
Zhang, Xinuo
Pan, Aixing
Lu, Hongyi
Wu, Bingchao
Liu, Yuzeng
author_sort Zhang, Yiqi
collection PubMed
description PURPOSE: This study aims to investigate the risk factors for screw loosening after single-level posterior lumbar interbody fusion (PLIF) utilizing cortical bone trajectory (CBT) screw and establish a nomogram for predicting screw loosening. METHODS: A total of 79 patients (316 screws) who underwent single-level PLIF with CBT screw were included in the study. Preoperative, postoperative, and final follow-up demographic data, surgical data, and radiographic parameters were documented and analyzed to identify risk factors, and a predictive nomogram was established for screw loosening. The nomogram was assessed by concordance index (C-index), calibration plot, decision curve analysis (DCA), and internal validation. RESULTS: The incidence of screw loosening was 26.6% in 79 patients and 11.4% in 316 screws. Multifactorial regression analysis confirmed that fixed to S1 (FS1, OR = 3.82, 95% CI 1.12–12.71, P = 0.029), the coronal angle of the screw (CA, OR = 1.07, 95% CI 1.01–1.14, P = 0.039), and cortical bone contacted layers (CBCLs, OR = 0.17, 95% CI 0.10–0.29, P < 0.001) were risk factors and incorporated in the nomogram for predicting screw loosening after single-level PLIF with a CBT screw. The C-index of the nomogram was 0.877 (95% CI 0.818–0.936), which demonstrated good predictive accuracy. The calibration plot indicated an acceptable calibration of the nomogram that also had a positive benefit in guiding treatment decisions. CONCLUSION: FS1, CA, and CBCLs are identified to be significant risk factors for screw loosening after single-level PLIF with the CBT technique. The nomogram we have established can be used to predict screw loosening and contribute to surgical decisions.
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spelling pubmed-96155602022-10-29 A nomogram for predicting screw loosening after single-level posterior lumbar interbody fusion utilizing cortical bone trajectory screw: A minimum 2-year follow-up study Zhang, Yiqi Li, Yue Hai, Yong Guan, Li Zhang, Xinuo Pan, Aixing Lu, Hongyi Wu, Bingchao Liu, Yuzeng Front Surg Surgery PURPOSE: This study aims to investigate the risk factors for screw loosening after single-level posterior lumbar interbody fusion (PLIF) utilizing cortical bone trajectory (CBT) screw and establish a nomogram for predicting screw loosening. METHODS: A total of 79 patients (316 screws) who underwent single-level PLIF with CBT screw were included in the study. Preoperative, postoperative, and final follow-up demographic data, surgical data, and radiographic parameters were documented and analyzed to identify risk factors, and a predictive nomogram was established for screw loosening. The nomogram was assessed by concordance index (C-index), calibration plot, decision curve analysis (DCA), and internal validation. RESULTS: The incidence of screw loosening was 26.6% in 79 patients and 11.4% in 316 screws. Multifactorial regression analysis confirmed that fixed to S1 (FS1, OR = 3.82, 95% CI 1.12–12.71, P = 0.029), the coronal angle of the screw (CA, OR = 1.07, 95% CI 1.01–1.14, P = 0.039), and cortical bone contacted layers (CBCLs, OR = 0.17, 95% CI 0.10–0.29, P < 0.001) were risk factors and incorporated in the nomogram for predicting screw loosening after single-level PLIF with a CBT screw. The C-index of the nomogram was 0.877 (95% CI 0.818–0.936), which demonstrated good predictive accuracy. The calibration plot indicated an acceptable calibration of the nomogram that also had a positive benefit in guiding treatment decisions. CONCLUSION: FS1, CA, and CBCLs are identified to be significant risk factors for screw loosening after single-level PLIF with the CBT technique. The nomogram we have established can be used to predict screw loosening and contribute to surgical decisions. Frontiers Media S.A. 2022-09-13 /pmc/articles/PMC9615560/ /pubmed/36311946 http://dx.doi.org/10.3389/fsurg.2022.950129 Text en © 2022 Zhang, Li, Hai, Guan, Zhang, Pan, Lu, Wu and Liu. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) (https://creativecommons.org/licenses/by/4.0/) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Surgery
Zhang, Yiqi
Li, Yue
Hai, Yong
Guan, Li
Zhang, Xinuo
Pan, Aixing
Lu, Hongyi
Wu, Bingchao
Liu, Yuzeng
A nomogram for predicting screw loosening after single-level posterior lumbar interbody fusion utilizing cortical bone trajectory screw: A minimum 2-year follow-up study
title A nomogram for predicting screw loosening after single-level posterior lumbar interbody fusion utilizing cortical bone trajectory screw: A minimum 2-year follow-up study
title_full A nomogram for predicting screw loosening after single-level posterior lumbar interbody fusion utilizing cortical bone trajectory screw: A minimum 2-year follow-up study
title_fullStr A nomogram for predicting screw loosening after single-level posterior lumbar interbody fusion utilizing cortical bone trajectory screw: A minimum 2-year follow-up study
title_full_unstemmed A nomogram for predicting screw loosening after single-level posterior lumbar interbody fusion utilizing cortical bone trajectory screw: A minimum 2-year follow-up study
title_short A nomogram for predicting screw loosening after single-level posterior lumbar interbody fusion utilizing cortical bone trajectory screw: A minimum 2-year follow-up study
title_sort nomogram for predicting screw loosening after single-level posterior lumbar interbody fusion utilizing cortical bone trajectory screw: a minimum 2-year follow-up study
topic Surgery
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9615560/
https://www.ncbi.nlm.nih.gov/pubmed/36311946
http://dx.doi.org/10.3389/fsurg.2022.950129
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