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
PurposeThis 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.MethodsA total of 79 patients (316 screws) who underwent singl...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-09-01
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| Series: | Frontiers in Surgery |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fsurg.2022.950129/full |
| _version_ | 1811182026943889408 |
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| author | Yiqi Zhang Yue Li Yue Li Yong Hai Li Guan Xinuo Zhang Aixing Pan Hongyi Lu Bingchao Wu Yuzeng Liu |
| author_facet | Yiqi Zhang Yue Li Yue Li Yong Hai Li Guan Xinuo Zhang Aixing Pan Hongyi Lu Bingchao Wu Yuzeng Liu |
| author_sort | Yiqi Zhang |
| collection | DOAJ |
| description | PurposeThis 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.MethodsA 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.ResultsThe 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.ConclusionFS1, 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. |
| first_indexed | 2024-04-11T09:26:06Z |
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| id | doaj.art-bdae93f3a29d466581144fc9c2ffc0f1 |
| institution | Directory Open Access Journal |
| issn | 2296-875X |
| language | English |
| last_indexed | 2024-04-11T09:26:06Z |
| publishDate | 2022-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Surgery |
| spelling | doaj.art-bdae93f3a29d466581144fc9c2ffc0f12022-12-22T04:32:02ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2022-09-01910.3389/fsurg.2022.950129950129A nomogram for predicting screw loosening after single-level posterior lumbar interbody fusion utilizing cortical bone trajectory screw: A minimum 2-year follow-up studyYiqi Zhang0Yue Li1Yue Li2Yong Hai3Li Guan4Xinuo Zhang5Aixing Pan6Hongyi Lu7Bingchao Wu8Yuzeng Liu9Department of Orthopedics, Beijing Chaoyang Hospital, Capital Medical University, Beijing, ChinaDepartment of Orthopedics, Beijing Chaoyang Hospital, Capital Medical University, Beijing, ChinaDepartment of Orthopedics, The General Hospital of Taiyuan Iron / Steel (Group) Corporation, Taiyuan, ChinaDepartment of Orthopedics, Beijing Chaoyang Hospital, Capital Medical University, Beijing, ChinaDepartment of Orthopedics, Beijing Chaoyang Hospital, Capital Medical University, Beijing, ChinaDepartment of Orthopedics, Beijing Chaoyang Hospital, Capital Medical University, Beijing, ChinaDepartment of Orthopedics, Beijing Chaoyang Hospital, Capital Medical University, Beijing, ChinaDepartment of Orthopedics, Beijing Chaoyang Hospital, Capital Medical University, Beijing, ChinaDepartment of Orthopedics, Beijing Chaoyang Hospital, Capital Medical University, Beijing, ChinaDepartment of Orthopedics, Beijing Chaoyang Hospital, Capital Medical University, Beijing, ChinaPurposeThis 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.MethodsA 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.ResultsThe 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.ConclusionFS1, 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.https://www.frontiersin.org/articles/10.3389/fsurg.2022.950129/fullcortical bone trajectoryscrew looseninglumbar spinenomogramspine |
| spellingShingle | Yiqi Zhang Yue Li Yue Li Yong Hai Li Guan Xinuo Zhang Aixing Pan Hongyi Lu Bingchao Wu Yuzeng Liu 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 Frontiers in Surgery cortical bone trajectory screw loosening lumbar spine nomogram spine |
| 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 | cortical bone trajectory screw loosening lumbar spine nomogram spine |
| url | https://www.frontiersin.org/articles/10.3389/fsurg.2022.950129/full |
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