Evidence map›Paper›PMID 42340436›Full record

ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2026

Lumbar degenerative disease: association of serum complement levels with diagnosis, structural severity, and postoperative prognosis.

Zaiyin Deng, Xiaoxuan Zhu, Yiqiu Cao, Ning Xie, Bin Ma, Yan Yu, Jianjie Wang, Wei Liu, Rongjing Di, Xiao Hu and 4 more

Abstract read
PubMed Publisher
In one paragraph

Article in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Zaiyin Deng *Division of Spine, Department of Orthopedics, Tongji Hospital affiliated to Tongji University, School of Medicine, Tongji University, Shanghai, China.
Xiaoxuan Zhu *Division of Spine, Department of Orthopedics, Tongji Hospital affiliated to Tongji University, School of Medicine, Tongji University, Shanghai, China.
Yiqiu CaoDivision of Spine, Department of Orthopedics, Tongji Hospital affiliated to Tongji University, School of Medicine, Tongji University, Shanghai, China.
Ning XieDivision of Spine, Department of Orthopedics, Tongji Hospital affiliated to Tongji University, School of Medicine, Tongji University, Shanghai, China.
Bin MaDivision of Spine, Department of Orthopedics, Tongji Hospital affiliated to Tongji University, School of Medicine, Tongji University, Shanghai, China.
Yan YuDivision of Spine, Department of Orthopedics, Tongji Hospital affiliated to Tongji University, School of Medicine, Tongji University, Shanghai, China.
Jianjie WangDivision of Spine, Department of Orthopedics, Tongji Hospital affiliated to Tongji University, School of Medicine, Tongji University, Shanghai, China.
Wei LiuDivision of Spine, Department of Orthopedics, Tongji Hospital affiliated to Tongji University, School of Medicine, Tongji University, Shanghai, China.
Rongjing DiDivision of Spine, Department of Orthopedics, Tongji Hospital affiliated to Tongji University, School of Medicine, Tongji University, Shanghai, China.
Xiao HuDivision of Spine, Department of Orthopedics, Tongji Hospital affiliated to Tongji University, School of Medicine, Tongji University, Shanghai, China.
Wei XuDivision of Spine, Department of Orthopedics, Tongji Hospital affiliated to Tongji University, School of Medicine, Tongji University, Shanghai, China.
Chen LiDivision of Spine, Department of Orthopedics, Tongji Hospital affiliated to Tongji University, School of Medicine, Tongji University, Shanghai, China.
Zhourui WuDivision of Spine, Department of Orthopedics, Tongji Hospital affiliated to Tongji University, School of Medicine, Tongji University, Shanghai, China. wuzhourui@tongji.edu.cn.
Liming ChengDivision of Spine, Department of Orthopedics, Tongji Hospital affiliated to Tongji University, School of Medicine, Tongji University, Shanghai, China. limingcheng@tongji.edu.cn.

Funding

the General Program of the National Natural Science Foundation of China 82371378the National Key Clinical Specialty Discipline Construction Program of China Z155080000004the Shanghai Key Discipline Clinical Research Center Construction Program 2023ZZ02016
6 · The paper itself

Abstract

purposeThe clinical evaluation of lumbar degenerative disease (LDD) severity relies on symptoms and imaging, lacking biologically specific diagnostic markers. This study investigated the role of serum complements in LDD to assess their potential as diagnostic biomarkers, their correlation with anatomical stenosis, and their ability to predict postoperative recovery. We hypothesized that specific serum complement levels correlate with both structural severity and clinical outcomes.

methodsA prospective investigation was conducted on 82 patients with LDD and 90 healthy controls. To minimize selection bias, a 1:1 propensity score matching (PSM) was performed for age and gender, resulting in a matched cohort of 112 participants. Serum levels of C1q, C3, and C4 were compared, while CRP and ESR were screened to exclude systemic inflammation. Anatomical severity was quantified using the S1/S0 ratio (dural sac area ratio) on MRI. Pain intensity was evaluated via Visual Analogue Scale (VAS) scores; quality of life was appraised using ODI and Barthel scales. Surgical prognosis was defined by achieving the Minimal Clinically Important Difference (MCID, ΔVAS ≥ 1.6) at 2-month follow-up.

resultsSerum C1q levels were significantly higher in the LDD group compared to controls (184.62 vs. 156.51 g/L, P = 0.001), whereas C3 and C4 showed no significant difference. Baseline CRP and ESR levels were within normal ranges, confirming the specificity of complement activation. ROC analysis demonstrated that C1q effectively distinguished LDD patients (AUC = 0.688), with an optimal cut-off of 154.40 g/L. Serum C4 levels exhibited a significant inverse correlation with the S1/S0 ratio (β = -0.867, P = 0.004). Baseline C1q was an independent predictor of failing to achieve MCID (OR = 0.980, P = 0.010). Patients who did not attain MCID had significantly higher baseline C1q levels. The rate of achieving MCID was lower in the highest C1q quartile (Q4: 52.6%) compared to the lowest (Q1: 75.0%).

conclusionSerum C1q and C4 serve as dual biomarkers in LDD. C4 correlates with anatomical stenosis severity, while C1q predicts surgical prognosis. Integration of serum complement profiling and radiological imaging improves preoperative risk stratification and facilitates surgical decision-making.

Indexed as

BiomarkerC1qC4ComplementsLumbar degenerative diseaseSurgical prognosis

Identifiers

PMID42340436

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.