Development and Validation of a Nomogram to Predict the Risk of Lumbar Disk Reherniation within 2 Years After Percutaneous Endoscopic Lumbar Discectomy

He, Hongping; Ma, Jun; Xiong, Chengjie; Wei, Tanjun; Tang, Aolin; Chen, Yongkang; Xing, Feng

doi:10.1016/j.wneu.2023.01.026

Cited by 6 publications

(10 citation statements)

References 28 publications

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“…A total of 3 studies ( 19 , 25 , 27 ) reported the association of the Pfirrmann grade with rLDH. The meta-analysis results showed that a Pfirrmann grade ≥4 was a risk factor for rLDH after PELD (OR=2.84, 95% CI: 1.30 to 6.16) and this association was statistically significant (P=0.008).…”

Section: Resultsmentioning

confidence: 99%

Associations of recurrent lumbar disc herniation after percutaneous endoscopic lumbar discectomy with age, body mass index, modic change, disc degeneration and sacral slope: A quantitative review

Zhao,

Zeng,

Zhao

et al. 2024

Exp Ther Med

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Recurrent lumbar disc herniation (rLDH) seriously affects the quality of life of patients and increases the medical burden. The purpose of the present study was to determine the risk factors for rLDH after percutaneous endoscopic lumbar discectomy (PELD). The PubMed, Cochrane Library and Embase databases were searched for studies on the factors associated with rLDH after PELD. The databases were searched from inception to March 30, 2023. The combined effects of categorical variables and continuous variables were measured using odds ratios (ORs) and weighted mean differences (WMDs), respectively, and their corresponding 95% confidence intervals (CIs) were calculated. RevMan 5.3 software was used for data analysis. A total of 9 case-control studies were included in this meta-analysis, comprising 5,446 patients. This study explored a total of 18 potential risk factors for rLDH after PELD; ultimately, 5 factors were associated with the risk of rLDH. Meta-analysis showed that older age (WMD=6.49, 95% CI: 2.52 to 10.46), greater body mass index (WMD=1.16, 95% CI: 0.69 to 1.62), modic change (OR=2.48, 95% CI: 1.54 to 3.99), Pfirrmann grade ≥4 (OR=2.84, 95% CI: 1.3 to 6.16) and greater sacral slope angle (WMD=3.48, 95% CI: 0.53 to 6.42) were risk factors for rLDH after PELD. The risk factors identified in the present study may enable clinicians to identify high-risk populations early and to select appropriate surgical procedures to reduce the risk of rLDH. Perioperative interventions targeting the modifiable factors identified in this study may be beneficial for reducing the risk of rLDH.

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Section: Resultsmentioning

confidence: 99%

Associations of recurrent lumbar disc herniation after percutaneous endoscopic lumbar discectomy with age, body mass index, modic change, disc degeneration and sacral slope: A quantitative review

Zhao,

Zeng,

Zhao

et al. 2024

Exp Ther Med

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“…Many scholars at home and abroad have explored the study of treatment prognosis of LDH patients and have established visualization prediction models. [14–16] However, most of the above clinical prediction models are single-center, exploring the postoperative prognosis of LDH patients. For example, one study retrospectively collected clinical data related to LDH patients treated with tubular microdiscectomy technique, and constructed and validated a prediction model for predicting the rate of improvement in the treatment of LDH patients with tubular microdiscectomy at 1 year postoperatively.…”

Section: Discussionmentioning

confidence: 99%

“…[13] Most scholars at home and abroad have explored the research on the prognosis of LDH patient treatment and have established visualization prediction models. [14–16] However, most of the above clinical prediction models explore the prognosis of postoperative patients, which limits the clinical application to some extent. In view of adverse outcomes, early warning and decision-making are needed in clinical practice.…”

Section: Introductionmentioning

confidence: 99%

Estimating surgical probability: Development and validation of a prognostic model for patients with lumbar disc herniation treated with acupuncture

Chen,

Lv,

et al. 2023

Medicine

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Lumbar disc herniation (LDH) is a common cause of pain in the lumbar spine and legs. While acupuncture has become the primary conservative treatment for LDH, some patients experience treatment failure and require surgery, causing substantial concern for clinicians. We developed an effective personalized clinical prediction model to identify the independent risk factors associated with acupuncture failure in patients with LDH. Our model aimed to predict the probability of surgery within 6 months of acupuncture failure in patients with LDH. A total of 738 patients with LDH who underwent acupuncture at 4 Chinese hospitals between January 2019 and October 2021 were selected. The patients were divided into training (n = 496) and validation (n = 242) cohorts. Seven predictive variables, including smoking, Oswestry Disability Index (ODI) score, lower-limb herniation, disc herniation type, lumbar spinal stenosis, lumbar lateral recess stenosis, and acupuncture frequency, were selected as risk factors using least absolute shrinkage and selection operato (LASSO) regression. A prediction model was developed using multivariate logistic regression analysis and a nomogram was constructed. The model exhibited good discrimination, with an area under the ROC curve (AUC) of 0.903 for the development cohort and 0.899 for the validation cohort. The Hosmer-Lemeshow goodness-of-fit test was a good fit for both cohorts (P = .956 for the development cohort; P = .513 for the validation cohort). Decision curve analysis (DCA) demonstrated that the threshold probabilities for the 2 cohorts ranged from > 4% and 5–95%, respectively. Therefore, the prediction model had a good net benefit. The nomogram established in this study, incorporating 7 risk factors, demonstrated a good predictive ability. It could predict acupuncture failure in LDH patients and the risk of surgery within 6 months, enabling physicians to conduct individualized treatment measures.

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“…Integrins, a class of cell surface adhesion molecules with signal transduction functions, serve a crucial role in virtually every phase of tumor proliferation and metastasis. Recent research indicates that homoharringtonine may inhibit the growth of bladder cancer by inactivating the integrin 5/1-FAK/Src axis ( 7 ). Collagen induces senescence in tumor cells by activating the p53/p21 pathway via the integrin 1/AKT axis ( 8 ).…”

Section: Bladder Cancer (Bca)mentioning

confidence: 99%

Editorial: The mechanism of tumor evolution and microenvironmental changes of genitourinary oncology in clinical diagnosis and treatment

Lu,

Xu,

Zhang

et al. 2023

Front. Oncol.

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Development and Validation of a Nomogram to Predict the Risk of Lumbar Disk Reherniation within 2 Years After Percutaneous Endoscopic Lumbar Discectomy

Cited by 6 publications

References 28 publications

Associations of recurrent lumbar disc herniation after percutaneous endoscopic lumbar discectomy with age, body mass index, modic change, disc degeneration and sacral slope: A quantitative review

Associations of recurrent lumbar disc herniation after percutaneous endoscopic lumbar discectomy with age, body mass index, modic change, disc degeneration and sacral slope: A quantitative review

Estimating surgical probability: Development and validation of a prognostic model for patients with lumbar disc herniation treated with acupuncture

Editorial: The mechanism of tumor evolution and microenvironmental changes of genitourinary oncology in clinical diagnosis and treatment

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