关键词:

老年胸腰椎爆裂骨折, 神经损伤, 危险因素, 列线图

Abstract:

Objective To construct a risk prediction model of nerve injury after thoracolumbar burst fracture in the elderly based on nomogram. Methods 169 patients with thoracolumbar burst fractures treated in hospital from January 2020 to January 2022 were selected as the research object. According to the occurrence of nerve injury，they were divided into nerve injury group（n = 54）and non⁃nerve injury group（n = 115）. The vari⁃ ables with statistical differences were screened by univariate analysis for multivariate logistic regression analysis， and the nomogram prediction model was established. Results Univariate analysis showed that there were significant differences between the two groups in age，injured segment T12/L1，intraspinal space occupying and posterior liga⁃ ment complex injury（P < 0.05）. Multivariate logistic regression showed that age ≥ 70 years old（OR = 2.684，P = 0.010），injured segment T12/L1（OR = 2.173，P = 0.042），intraspinal space occupying（OR = 2.595，P = 0.010） and posterior ligament complex injury（OR = 3.416，P = 3.416）were independent risk factors for nerve injury after thoracolumbar burst fracture in the elderly（P < 0.05）. Based on this，a nomogram model for predicting the risk of nerve injury after thoracolumbar burst fracture in the elderly was established. The model verification results showed that the C⁃index was 0.773，the correction curve was close to the ideal curve，and the area under the ROC curve（AUC）was 0.755（95%CI：0.715 ~ 0.794）. Within the range of 8% ~ 82%，the nomogram model had a net benefit. Conclusion Age ≥ 70 years old，injured segment T12/L1，intraspinal space occupying and posterior ligament complex injury will increase the risk of nerve injury after thoracolumbar burst fracture in the elderly. The nomogram model can effectively predict the risk probability of nerve injury after thoracolumbar burst fracture amongst the elderly.

Key words:

thoracolumbar burst fracture in the elderly, nerve injury, risk factors, nomogram