A neurological prognostic nomogram integrating biomarkers and clinical indicators for surgically treated patients with osteoporotic spinal fracture and spinal cord injury

To construct and validate a prediction model of neurological rehabilitation for patients with osteoporotic spinal fracture combined with spinal cord injury based on the expression of serum neurotrophic factor (Neuritin) and transforming growth factor β1 (TGF-β1 ), so as to provide basis for accurate clinical rehabilitation. A total of 189 patients with osteoporotic spinal fracture combined with spinal cord injury who were admitted to our hospital from January 2022 to September 2024 were included in the study. A random 7:3 score was used as the training set (n = 132) and validation set (n = 57). In the training set, independent influencing factors were screened by univariate and multivariate Logistic regression analysis, and a Nomogram model was constructed. The model performance was evaluated by using the consistency index (C-index), calibration curve, and receiver operating characteristic curve (ROC), and was verified in the validation set. There was no significant difference in baseline data between the training set and the validation set (P > 0.05). Multivariate logistic analysis showed that serum Neuritin (ng/mL, OR = 1.285), TGF-β1 (ng/mL, OR = 0.979), vertebral compression degree (%) (OR = 0.960), spinal canal space-occupying rate (%) (OR = 0.879), 25-hydroxyvitamin D (ng/mL, OR = 1.103), and alkaline phosphatase (U/L, OR = 0.973) were the independent factors for poor neurological rehabilitation (all P < 0.05). The C-index for the nomogram model was 0.842 and 0.821 in the training and validation sets, respectively, the calibration curve fitted well, and the area under the ROC curve (AUC) was 0.850 (95% CI: 0.75–0.95) and 0.826 (95% CI: 0.65-1.00), respectively. The Nomogram model constructed based on serum levels of Neuritin and TGF-β1 can effectively predict the neurological rehabilitation effects of patients with osteoporotic spinal fracture combined with spinal cord injury, and has potential clinical application value.