Objective To explore the risk factors affecting postoperative residual low back pain(PRLBP)after percutaneous en-doscopic lumbar discectomy(PELD)and construct a nomogram for predicting PRLBP.Methods A total of 113 patients with lumbar disc herniation(LDH)who underwent PELD surgery in our hospital from January 2019 to December 2022 were selected as the study subjects.The patients were randomly divided into a training cohort and a validation cohort at a ratio of 6:4.Univariate and multivariate Logistic analyses were performed on the training cohort to determine independent prognostic factors and construct a nomogram.The vali-dation cohort was used to validate the performance of the nomogram.The discriminatory ability of the nomogram was evaluated using the receiver operating characteristic(ROC)curve and the area under the curve(AUC).The calibration curve was used to assess the con-sistency between actual and predicted results.Decision curve analysis(DCA)was used to calculate the net benefit of the prediction model.Results According to the inclusion and exclusion criteria,a total of 113 patients after PELD surgery were included,among whom 28 patients had a VAS score of ≥4 at 4 weeks after surgery,and the incidence of PRLBP was 24.78％.Multivariate Logistic re-gression analysis showed that age,Modic changes,paraspinal muscle infiltration index,and lumbar fascia edema were associated with PRLBP(P＜0.05).The internal and external calibration curves showed good consistency of the PRLBP prediction nomogram.The DCA curve showed that the nomogram exhibited good net benefit and clinical effectiveness.ROC analysis showed that the AUC of the training cohort was 0.902(95％CI:0.851-0.953),and the AUC of the validation cohort was 0.897(95％CI:O.846-0.948).Conclusions Age,Modic changes,lumbar fascia edema,and paraspinal muscle fat infiltration index are independent risk factors for PRLBP in patients undergoing PELD surgery.The constructed nomogram can effectively predict the risk of PRLBP occurrence.
关键词
腰椎间盘突出症/经皮内窥镜下腰椎间盘切除术/术后残余腰痛/诺模图
Key words
lumbar disc herniation/percutaneous endoscopic lumbar discectomy/postoperative residual low back pain/nomogram
维普
万方数据