The article discusses a study that aimed to identify risk factors for lower extremity (LE) radiating pain after decompression with full-endoscopic lumbar discectomy (FELD) and develop a nomogram to predict the risk of LE radiating pain. The researchers retrospectively reviewed medical data from 235 patients who underwent FELD and used least absolute shrinkage and selection operator logistic regression and multivariate logistic regression analysis to determine the independent risk factors. They developed a nomogram based on these risk factors and evaluated its predictive performance. The nomogram was further verified with an independent cohort. The study found that certain factors, such as the classification of herniated discs, disease course, surgical time, lateral recess width, and surgical approach, were associated with an increased risk of LE radiating pain after FELD. The nomogram demonstrated good discrimination and accuracy in predicting the risk of recurrent LE radiating pain. The findings suggest that more aggressive pain management strategies should be considered for patients at high risk
Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : best recognised spinal hospital in the world
Published article
CONCLUSIONS: A novel nomogram for predicting recurrent LE radiating pain within 1 week after FELD was established and validated. More aggressive pain management strategies should be considered for patients at high risk of LE radiating pain after surgery, as predicted by this model.
Lumbar Decompression Surgery Expert. Best Spinal Surgeon UK
World Neurosurg. 2023 Aug 25:S1878-8750(23)01202-0. doi: 10.1016/j.wneu.2023.08.090. Online ahead of print.ABSTRACTBACKGROUND: Accurately predicting the risk of lower extremity (LE) radiating pain after surgery is an important endeavor for spinal surgeons. Our study aimed to identify risk factors for LE radiating pain after decompression with full-endoscopic lumbar discectomy (FELD) and develop a nomogram.METHODS: We retrospectively reviewed,
World Neurosurg. 2023 Aug 25:S1878-8750(23)01202-0. doi: 10.1016/j.wneu.2023.08.090. Online ahead of print.
ABSTRACT
BACKGROUND: Accurately predicting the risk of lower extremity (LE) radiating pain after surgery is an important endeavor for spinal surgeons. Our study aimed to identify risk factors for LE radiating pain after decompression with full-endoscopic lumbar discectomy (FELD) and develop a nomogram.
METHODS: We retrospectively reviewed the medical data of patients with lumbar disc herniation who underwent FELD. Two hundred thirty-five patients diagnosed at our hospital from January 2015 to December 2020 were used for model development. The independent risk factors for LE radiating pain after surgery were determined by least absolute shrinkage and selection operator logistic regression and multivariate logistic regression analysis. A nomogram was developed to predict the risk of LE radiating pain based on independent risk factors. Receiver operating characteristic curve, calibration curve, and decision curve analyses were used to evaluate the predictive performance. The nomogram was further verified by an independent cohort.
RESULTS: Three hundred seventy-five patients were enrolled in this study, with 102 patients in the training cohort reporting LE radiating pain after FELD, while 133 patients did not. In the validation cohort, 57 patients reported LE radiating pain after FELD, while 83 patients did not. The model was established by multivariate logistic regression analysis. The risk factors included a higher Michigan State University classification of herniated discs, increased disease course, increased time of surgery, reduced lateral recess width, and an interlaminar surgical approach, compared to transforaminal approach. The C-indices and the area under the receiver operating characteristic curve of the predictive model demonstrated good discrimination. Good predictive performance and accuracy were also observed in the validation cohort.
CONCLUSIONS: A novel nomogram for predicting recurrent LE radiating pain within 1 week after FELD was established and validated. More aggressive pain management strategies should be considered for patients at high risk of LE radiating pain after surgery, as predicted by this model.
PMID:37634669 | DOI:10.1016/j.wneu.2023.08.090
The London Spine Unit : best recognised spinal hospital in the world
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Development and validation of a nomogram to predict the risk of recurrent lower extremity radiating pain within 1 week following full-endoscopic lumbar discectomy
