ORIGINAL RESEARCH article
Front. Surg.
Sec. Orthopedic Surgery
Volume 12 - 2025 | doi: 10.3389/fsurg.2025.1564825
This article is part of the Research TopicMinimally Invasive Treatments for Lumbar Spine DisordersView all 10 articles
Nomogram for prediction of recurrence in patients with lumbar disc herniation after unilateral biportal endoscopy spinal surgery: a retrospective study
Provisionally accepted
Yi Rong1
TianChi Zhang2Kaixuan Wang2,3
Yong Ma2,3,4
Lining Wang2,3,5
Yang Guo6Si Chen1Yang Shao1TingChen Zhu1ShiXiang Wu1Zhen Hua1
Jianwei Wang1Yalan Pan2,7Hao Yu1*- 1Department of Traumatology & Orthopedics, Wuxi Affiliated Hospital of Nanjing University of Chinese Medicine, Wuxi 214071, China, Nanjing City, China
- 2Laboratory of New Techniques of Restoration & Reconstruction, Institute of Traumatology & Orthopedics, Nanjing University of Chinese Medicine, Nanjing 210023, China., Nanjing City, China
- 3School of Integrative Medicine, Nanjing University of Chinese Medicine, No. 138, Xianlin Road, Qixia District, Nanjing City, Jiangsu 210023, China., Nanjing City, China
- 4Department of Traumatology & Orthopedics, Yancheng Affiliated Hospital of Nanjing University of Chinese Medicine, Yancheng 224002, China., Yancheng city, China
- 5Department of Orthopedic Surgery, Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine, Nanjing 210022, China., Nanjing City, China
- 6Nanjing University of Chinese Medicine, Nanjing, China
- 7School of Nursing, Nanjing University of Chinese Medicine, No. 138, Xianlin Road, Qixia District, Nanjing City, Jiangsu 210023, China., Nanjing City, China
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This study aimed to construct a nomogram to predict the likelihood of early recurrence in patients with lumbar disc herniation (LDH) following unilateral biportal endoscopic (UBE) surgery.A retrospective analysis was conducted on LDH patients who underwent UBE surgery in our department between January 1, 2022, and December 31, 2023. The eligible cohort was randomly divided into training and validation sets in a 7:3 ratio. Key predictors for the nomogram were identified through a combination of least absolute shrinkage and selection operator (LASSO) regression and multivariate logistic regression analysis. The model's performance was assessed using the C-index, the area under the receiver operating characteristic curve (AUC), calibration curves, and decision curve analysis. The validation set was used to further evaluate the model's robustness.A total of 289 patients were included in the study, among whom 50 experienced recurrent LDH (rLDH). Five risk factors were identified as significant predictors for rLDH: width of protrusion base (WPB), bone removal range (BRR), Modic changes, type of LDH, and middle vertebral space height (MVH). The C-index values for the training and validation sets were 0.834 and 0.804, respectively. The AUC values were 0.834 (95% CI: 0.750-0.918) in the training set and 0.804 (95% CI: 0.697-0.910) in the validation set. Calibration curves
Keywords: LDH, UBE, Recurrence, nomogram, Prediction model
Received: 22 Jan 2025; Accepted: 30 Apr 2025.
Copyright: © 2025 Rong, Zhang, Wang, Ma, Wang, Guo, Chen, Shao, Zhu, Wu, Hua, Wang, Pan and Yu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Hao Yu, Department of Traumatology & Orthopedics, Wuxi Affiliated Hospital of Nanjing University of Chinese Medicine, Wuxi 214071, China, Nanjing City, China
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