Risk Factors and Risk Prediction Model Construction of Low Back Pain After Intervertebral Foramen Endoscopy in Patients with Degenerative Lumbar Spinal Stenosis
Objective To analyze the risk factors of low back pain in patients with degenerative lumbar spinal stenosis(DLSS)after intervertebral foramen endoscopic surgery and to establish a risk prediction model.Methods A prospective analysis was used in this study,and 86 patients with DLSS who were treated by percutaneous intervertebral foramen surgery in Nanyang Central Hospital from July 2020 to July 2022 were included in the study.They were followed up for 3 months after surgery.According to the occurrence of postoperative low back pain,they were divided into the occurrence group and the non occurrence group.The clinical data of the two groups of patients were analyzed,and the influencing factors of the occurrence of low back pain in DLSS patients after intervertebral foramen endoscopy were analyzed by multifactorial logistic regression.The risk prediction model was constructed,and the receiver operating characteristic(ROC)curve was drawn to evaluate the prediction efficiency of the risk model.Results Following up for 3 months,21 of 86 patients with DLSS developed low back pain after intervertebral foramen endoscopy,the incidence rate was 24.42％(21/86).There were statistical significant differences in the occurrence group of osteoporosis,intraoperative clearance of intervertebral spaces,postoperative aseptic inflammation in the spinal canal(P＜0.05).Multivariate logistic regression analysis showed that osteoporosis,clearance of intervertebral space during operation,aseptic inflammation in vertebral canal after operation,and the time of first exercise were all risk factors for low back pain after intervertebral foramen endoscopy in DLSS patients(P＜0.05).The risk model was constructed,and the verification model showed that the C-index value was 0.870,which had good discrimination.The standard curve was drawn,and the calibration curve was similar to the Y-X straight line,and the model accuracy was good.The predictive efficacy of the model was verified.The results showed that the area under the curve(AUC)of the risk model for evaluating the occurrence of low back pain in DLSS patients after intervertebral foramen was 0.870,and the 95％CI was 0.779-0.961,P＜0.001.Conclusion The incidence of low back pain in DLSS patients after intervertebral foramen endoscopic surgery is high.The risk factors of low back pain in DLSS patients after intervertebral foramen endoscopic surgery are osteoporosis,uncleaned intervertebral space during surgery,aseptic inflammation in the spinal canal after surgery,and prolonged first exercise time.The risk model based on the above factors has a high evaluation value for whether there is low back pain in DLSS patients after intervertebral foramen endoscopic surgery.
degenerative lumbar spinal stenosisintervertebral foramen endoscopypostoperative lower back painrisk factorrisk model
万方数据
维普
