Abstract：
OBJECTIVE: The literature is scarce in exploring the role of imaging parameters like ultrasound (US) as a biomarker for surgical outcomes. The purpose of this study is to investigate the associations between skin US parameters and revision surgery following spine lumbar fusion.
METHODS: Posterior lumbar fusion patients with 2-years follow-up were assessed. Previous fusion or revision not due to adjacent segment disease (ASD) were excluded. Revisions were classified as cases and non-revision were classified as controls. US measurements conducted at two standardized locations on the lumbar back. Skin echogenicity of the average dermal (AD), upper 1/3 of the dermal (UD), lower 1/3 of the dermal (LD), and subcutaneous layer were measured. Echogenicity was calculated with the embedded echogenicity function of our institution\'s imaging platform (PACS). Statistical significance was set at p < 0.05.
RESULTS: A total of 128 patients (51% female, age 62 [54-72] years) were included in the final analysis. 17 patients required revision surgery. AD, UD, and LD echogenicity showed significantly higher results among revision cases 124.5 [IQR = 115.75,131.63], 128.5 [IQR = 125,131.63] and 125.5 [IQR = 107.91,136.50] compared to the control group 114.3 [IQR = 98.83,124.8], 118.5 [IQR = 109.28,127.50], 114 [IQR = 94.20,126.75] respectively.
CONCLUSIONS: The findings of this study demonstrate a significant association between higher echogenicity values in different layers of the dermis and requiring revision surgery. The results provide insights into the potential use of skin US parameters as predictors for revision surgery. These findings may reflect underlying alterations in collagen. Further research is warranted to elucidate the mechanisms driving these associations.
METHODS: Posterior lumbar fusion patients with 2-years follow-up were assessed. Previous fusion or revision not due to adjacent segment disease (ASD) were excluded. Revisions were classified as cases and non-revision were classified as controls. US measurements conducted at two standardized locations on the lumbar back. Skin echogenicity of the average dermal (AD), upper 1/3 of the dermal (UD), lower 1/3 of the dermal (LD), and subcutaneous layer were measured. Echogenicity was calculated with the embedded echogenicity function of our institution\'s imaging platform (PACS). Statistical significance was set at p < 0.05.
RESULTS: A total of 128 patients (51% female, age 62 [54-72] years) were included in the final analysis. 17 patients required revision surgery. AD, UD, and LD echogenicity showed significantly higher results among revision cases 124.5 [IQR = 115.75,131.63], 128.5 [IQR = 125,131.63] and 125.5 [IQR = 107.91,136.50] compared to the control group 114.3 [IQR = 98.83,124.8], 118.5 [IQR = 109.28,127.50], 114 [IQR = 94.20,126.75] respectively.
CONCLUSIONS: The findings of this study demonstrate a significant association between higher echogenicity values in different layers of the dermis and requiring revision surgery. The results provide insights into the potential use of skin US parameters as predictors for revision surgery. These findings may reflect underlying alterations in collagen. Further research is warranted to elucidate the mechanisms driving these associations.
摘要：
目的：在探讨超声（US）等成像参数作为手术结果生物标志物的作用方面，文献很少。这项研究的目的是研究脊柱腰椎融合术后皮肤US参数与翻修手术之间的关系。
方法：对随访2年的腰椎后路融合患者进行评估。排除先前不是由于相邻节段疾病（ASD）引起的融合或翻修。修订被分类为病例，非修订被分类为对照。在腰部背部的两个标准化位置进行美国测量。平均真皮（AD）的皮肤回声，真皮上部1/3（UD），真皮下1/3（LD），并测量皮下层。使用我们机构的成像平台（PACS）的嵌入式回声功能计算回声。统计学显著性设定为p<0.05。
结果：共有128名患者（51%为女性，年龄62[54-72]岁)纳入最终分析。17例患者需要翻修手术。AD,UD,在修正病例124.5[IQR=115.75,131.63]中，LD回声显示出明显更高的结果，128.5[IQR=125,131.63]和125.5[IQR=107.91,136.50]与对照组114.3[IQR=98.83,124.8]相比，118.5[IQR=109.28,127.50]，114[IQR=94.20,126.75]。
结论：这项研究的结果表明，真皮不同层的较高回声值与需要翻修手术之间存在显著关联。结果提供了有关皮肤US参数作为翻修手术预测因子的潜在用途的见解。这些发现可能反映了胶原蛋白的潜在改变。需要进一步的研究来阐明驱动这些关联的机制。
方法：对随访2年的腰椎后路融合患者进行评估。排除先前不是由于相邻节段疾病（ASD）引起的融合或翻修。修订被分类为病例，非修订被分类为对照。在腰部背部的两个标准化位置进行美国测量。平均真皮（AD）的皮肤回声，真皮上部1/3（UD），真皮下1/3（LD），并测量皮下层。使用我们机构的成像平台（PACS）的嵌入式回声功能计算回声。统计学显著性设定为p<0.05。
结果：共有128名患者（51%为女性，年龄62[54-72]岁)纳入最终分析。17例患者需要翻修手术。AD,UD,在修正病例124.5[IQR=115.75,131.63]中，LD回声显示出明显更高的结果，128.5[IQR=125,131.63]和125.5[IQR=107.91,136.50]与对照组114.3[IQR=98.83,124.8]相比，118.5[IQR=109.28,127.50]，114[IQR=94.20,126.75]。
结论：这项研究的结果表明，真皮不同层的较高回声值与需要翻修手术之间存在显著关联。结果提供了有关皮肤US参数作为翻修手术预测因子的潜在用途的见解。这些发现可能反映了胶原蛋白的潜在改变。需要进一步的研究来阐明驱动这些关联的机制。
