Percutaneous transforaminal endoscopic discectomy combined with acupuncture for lumbar disc herniation: A protocol for systematic review and meta-analysis

Feng, Shu-gui; Yang, Qiang; Zhao, Lei; Wang, Guoqiang; Yang, Chenyi

doi:10.1097/md.0000000000032296

Cited by 2 publications

(1 citation statement)

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“…[ 8 ] Extensive research has proved the long-term efficacy and safety of acupuncture, effectively reducing the need for surgery. [ 9 , 10 ] Despite these positive outcomes, some patients did not experience improvement with acupuncture and resorted to surgery. This delay can result in missed opportunities for timely surgical intervention, leading to a prolonged disability, high treatment costs, and chronic pain.…”

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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Section: Introductionmentioning

confidence: 99%