Study on the Relationship between Preoperative Serum SRF,pNF-H,NLRP3 Levels and Poor Postoperative Prognosis in Patients Undergoing Surgery for Spinal Fractures Combined with Spinal Cord Nerve Injury
WU Zhilin
WANG Hao
HE Qin
WANG Pingxi
Abstract：Objective To investigate the relationship between the levels of preoperative serum response factor(SRF),phosphorylated subtype of neurofilament protein H(pNF-H),nucleotide-binding oligomerization domain-like receptor protein 3(NLRP3)and poor postoperative prognosis in patients undergoing surgery for spinal fractures combined with spinal cord nerve injury.Methods A total of 192 patients with spinal fractures combined with spinal cord nerve injury who were admit-ted from June 2021 to June 2023 were selected and all underwent surgical treatment.They were followed up for 1 year after operation,and 4 patients were lost to follow-up.According to the prognosis,they were divided into the good prognosis group(n=52)and the poor prognosis group(n=136).The clinical data of the two groups and the levels of preoperative serum SRF,pNF-H and NLRP3 were compared.The relationship between the levels of preoperative serum SRF,pNF-H and NLRP3 and the degree of spinal nerve injury as well as the poor prognosis after surgery was analyzed,and the predictive value of the levels of preoperative serum SRF,pNF-H and NLRP3 for the poor prognosis after surgery was evaluated.Results The preoperative serum SRF in the poor prognosis group was lower than that in the good prognosis group,while the degree of spinal nerve inju-ry,the rate of spinal canal invasion,pNF-H and NLRP3 were higher than those in the good prognosis group(P<0.01).The pre-operative serum SRF of patients with complete spinal cord injury was lower than that of patients with incomplete spinal cord injury,while pNF-H and NLRP3 were higher than those of patients with incomplete spinal cord injury(P<0.01).The preoperative serum SRF of patients with spinal canal invasion rate≥50%was lower than that of patients with spinal canal invasion rate<50%,while pNF-H and NLRP3 were higher than those of patients with spinal canal invasion rate<50%(P<0.01).Spearman correlation analysis showed that preoperative serum SRF was negatively correlated with the degree of spinal cord injury and the rate of spinal canal invasion in patients,while preoperative serum pNF-H and NLRP3 were positively correlated with the degree of spinal cord injury and the rate of spinal canal invasion in patients(P<0.01).The areas under the curves of preoperative serum SRF,pNF-H,and NLRP3 alone and in combination for predicting poor postoperative prognosis of patients were 0.780,0.798,0.808,and 0.935,respectively,and the value of combined prediction was the highest(P<0.01).Risk analysis showed that a low preoperative serum SRF level indicated an increased risk of poor postoperative prognosis by 4.925 times for patients,while high preoperative serum pNF-H and NLRP3 levels indicated an increased risk by 4.224 and 4.517 times,respectively(P<0.01).Conclusion The abnor-mal expressions of preoperative serum SRF,pNF-H and NLRP3 levels in patients with spinal fractures combined with spinal cord nerve injury are closely related to the degree of spinal cord injury,the rate of spinal canal invasion and poor prognosis.The three have high predictive value in the poor prognosis of patients after surgery.
Keywords：Spinal fractureSpinal cord nerve injurySerum response factorPhosphorylated subtype of neurofila-ment protein HNucleotide-binding oligomerization domain-like receptor protein 3Poor prognosisPredictive value
Publication Date：2025-07-13
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 62-67 )