基于多中心RCT的颈型颈椎病复发影响因素分析及风险预测模型构建OA

Objective:To identify independent factors influencing the recurrence of neck type cervical spondylosis(NTCS)and to develop a risk prediction model.Methods:Based on data from a multicenter randomized controlled trial,127 NTCS patients(46 in the recurrence group,81 in the non-recurrence group)were included.Demographic and clinical data were collected.Univariate and multivariate Logistic regression analyses were employed to identify factors associated with recur-rence,and predictive performance was evaluated using ROC curves.Results:Univariate analysis identified the pre-treat-ment C2 to C7 SVA value as a significant risk factor for NTCS recurrence.Multivariate analysis demonstrated that a his-tory of prolonged desk work and a higher pre-treatment NRS score were independent risk factors for recurrence,while ac-upuncture combined with health management served as a protective factor.The pre-treatment C2 to C7 SVA value showed a trend towards significance(P=0.051).ROC curve analysis revealed that the AUC values for the NRS score,C2 to C7 SVA value,and the combined prediction model were 0.647 9,0.642 8,and 0.703 0,respectively.Based on the Youden index,the optimal cutoff values were determined as NRS≥4.5 points,C2 to C7 SVA≥20.61 mm,and predicted proba-bility ≥ 0.2 694.The values corresponding to a 50％recurrence probability were 6.127 points and 27.17 mm,respectively.Conclusion:Prolonged desk work and a high baseline pain level are major risk factors for NTCS recur-rence,while acupuncture combined with health management can effectively reduce recurrence risk of recurrence.The pre-diction model incorporating the pain score and C2 to C7 SVA parameter demonstrates good discriminatory ability.