Neurospine.
2024 Mar;21(1):212-222. 10.14245/ns.2347152.576.
Role of Preoperative Albumin Quotient in Surgical Planning for Posttraumatic Syringomyelia: A Comparative Cohort Study
- Xia P1,2,3,4,5
- Lv H1,2,3,4,5
- Yuan C1,2,3,4,5
- Duan W1,2,3,4,5
- Wang J6
- Guan J1,2,3,4,5
- Du Y1,2,3,4,5
- Zhang C1,2,3,4,5
- Liu Z1,2,3,4,5
- Wang K1,2,3,4,5
- Wang Z1,2,3,4,5
- Wang X1,2,3,4,5
- Wu H1,2,3,4,5
- Chen Z1,2,3,4,5
- Jian F
1,2,3,4,5
- Affiliations
-
- 1Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
- 2Spine Center, China International Neuroscience Institute (CHINA-INI), Beijing, China
- 3Research Center of Spine and Spinal Cord, Beijing Institute of Brain Disorders, Capital Medical University, Beijing, China
- 4National Center for Neurological Disorders, Beijing, China
- 5Lab of Spinal Cord Injury and Functional Reconstruction, China International Neuroscience Institute (CHINA-INI), Beijing, China
- 6Xuanwu Hospital, Beijing, China
- KMID: 2553922
- DOI: http://doi.org/10.14245/ns.2347152.576
Abstract
Objective
Surgical procedures for patients with posttraumatic syringomyelia (PTS) remain controversial. Until now, there have been no effective quantitative evaluation methods to assist in selecting appropriate surgical plans before surgery.
Methods
We consecutively enrolled PTS patients (arachnoid lysis group, n = 42; shunting group, n = 14) from 2003 to 2023. Additionally, 19 intrathecal anesthesia patients were included in the control group. All patients with PTS underwent physical and neurological examinations and spinal magnetic resonance imaging preoperatively, 3–12 months postoperatively and during the last follow-up. Preoperative lumbar puncture was performed and blood-spinal cord barrier disruption was detected by quotient of albumin (Qalb, cerebrospinal fluid/serum).
Results
The ages (p = 0.324) and sex (p = 0.065) of the PTS and control groups did not differ significantly. There were also no significant differences in age (p = 0.216), routine blood data and prognosis (p = 0.399) between the arachnoid lysis and shunting groups. But the QAlb level of PTS patients was significantly higher than that of the control group (p < 0.001), and the shunting group had a significantly higher QAlb (p < 0.001) than the arachnoid lysis group. A high preoperative QAlb (odds ratio, 1.091; 95% confidence interval, 1.004–1.187; p = 0.041) was identified as the predictive factor for the shunting procedure, with the receiver operating characteristic curve showing 100% specificity and 80.95% sensitivity for patients with a QAlb > 12.67.
Conclusion
Preoperative QAlb is a significant predictive factor for the types of surgery. For PTS patients with a QAlb > 12.67, shunting represents the final recourse, necessitating the exploration and development of novel treatments for these patients.
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