Predicting conservative treatment failure in patients with lumbar disc herniation. Single center, case-control study

Ostafiński, Krzysztof; Świątnicki, Wojciech; Szymański, Jarosław; Szymańska, Anna; Nowosławska, Emilia; Zakrzewski, Krzysztof; Komuński, Piotr

doi:10.1016/j.clineuro.2020.105867

Cited by 6 publications

(1 citation statement)

References 17 publications

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“…By conducting a literature review and considering the study objectives, 15 predictors were screened. [19][20][21][22] The basic characteristics and imaging findings of the patients were prospectively collected from each hospital care system. Potential predictive variables obtained at hospital admission included age, sex, body mass index (BMI), smoking (defined as daily consumption of more than 1 cigarette for a continuous or cumulative period of 6 months, persisting until 1 week before treatment), duration, Oswestry Disability Index (ODI) at admission, degree of positive straight leg raise test, lower limb muscle strength, lower limb sensation, disc herniation level and type, lumbar spondylolisthesis, lumbar spinal stenosis, and lumbar lateral recess stenosis.…”

Section: Potential Predictive Variablesmentioning

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: Potential Predictive Variablesmentioning

confidence: 99%