Construction and validation of a nomogram prediction model for postoperative recurrence of lumbar disc herniation treated with percutaneous laminectomy

Abstract

The aim was to investigate the independent risk factors for postoperative recurrence of lumbar disc herniation treated by percutaneous intervertebral laminectomy, and to establish a nomogram prediction model accordingly. Data on patients with lumbar disc herniation were collected from January 2018 to December 2023 in our hospital, and single-factor and multifactorial logistic regression analyses were used to determine the independent risk factors for postoperative recurrence of lumbar disc herniation and establish the corresponding nomogram. The receiver operating characteristic curves were plotted the area under the curve was calculated, and the calibration curves and decision curves were plotted to evaluate the model performance. A total of 644 patients with lumbar disc herniation were included in the study, and 61 patients had a postoperative recurrence, with a recurrence rate of 9.5%. After univariate and multivariate logistic regression model analysis, a total of 7 variables were identified as independent risk factors for postoperative recurrence of lumbar disc herniation: age > 60 years (OR, 3.709; 95% CI, 1.284–10.714), type of nucleus pulposus protrusion as herniation (OR, 7.342; 95% CI, 1.500–35.929), nucleus pulposus degeneration grade III-V (OR, 4.068; 95% CI, 1.214–13.627), operative segment L4–L5 (OR, 5.060; 95% CI, 1.659–15.431), incomplete intraoperative medullary removal (OR, 5.355; 95% CI, 2.017–14.220), and broken fibrous ring (OR, 5.229; 95% CI, 1.235–22.142), and postoperative high-intensity activity (OR, 5.096; 95% CI, 1.420–17.669). The nomogram constructed in this study for postoperative recurrence of lumbar disc herniation treated by percutaneous intervertebral foramenoscopy has good predictive accuracy, which helps orthopedic surgeons to intervene in advance in patients at high risk of postoperative recurrence of lumbar disc herniation treated by percutaneous intervertebral foramenoscopy.