Construction and validation: A nomogram model to predict recurrence after percutaneous endoscopic discectomy.

Area of Science:

• Neurosurgery
• Orthopedic Surgery
• Medical Technology

Background:

• Lumbar disc herniation (LDH) is a common condition requiring surgical intervention.
• Percutaneous endoscopic discectomy (PED) is a minimally invasive treatment for LDH.
• Postoperative recurrence remains a concern, necessitating identification of predictive factors.

Purpose of the Study:

• To identify independent risk factors for postoperative recurrence in patients undergoing PED for LDH.
• To construct and validate a nomogram prediction model for personalized recurrence risk assessment.
• To improve clinical decision-making and patient outcomes following PED.

Main Methods:

• Retrospective analysis of 286 patients with LDH treated with PED.
• Univariate and multivariate logistic regression analyses to identify risk factors.
• Development and validation of a nomogram using ROC, calibration, and decision curve analyses.

Main Results:

• The overall recurrence rate after PED was 10.14% (29/286 patients).
• Five independent risk factors for recurrence were identified: age > 60 years, BMI > 24 kg/m², herniation type, degeneration grade III-IV, and postoperative high-intensity activity.
• The constructed nomogram demonstrated good predictive accuracy and clinical utility.

Conclusions:

• Age, BMI, herniation type, degeneration grade, and postoperative activity level are significant predictors of recurrence after PED for LDH.
• The developed nomogram provides a valuable tool for orthopedic surgeons to stratify recurrence risk.
• This tool facilitates early intervention and individualized management strategies to optimize patient prognosis after PED.