Evidence map›Paper›PMID 41858414›Full record

ArticleRisk management and healthcare policy2026

Construction and Validation of a Nomogram Prediction Model for Recurrent Lumbar Disc Herniation After Percutaneous Endoscopic Lumbar Discectomy.

Zeyu Jiang, Ziying Cui, Yiping Yang, Haijun Li

Abstract read
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Article in Risk management and healthcare policy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

4 authors.

Zeyu Jiang *Department of Orthopedics, The Affiliated Taizhou People's Hospital of Nanjing Medical University, Taizhou School of Clinical Medicine, Nanjing Medical University, Taizhou, Jiangsu, People's Republic of China.
Ziying Cui *The Graduate School of Dalian Medical University, Dalian Medical University, Dalian, Liaoning, People's Republic of China.
Yiping Yang *Department of Orthopedics, The Affiliated Taizhou People's Hospital of Nanjing Medical University, Taizhou School of Clinical Medicine, Nanjing Medical University, Taizhou, Jiangsu, People's Republic of China.
Haijun LiDepartment of Orthopedics, The Affiliated Taizhou People's Hospital of Nanjing Medical University, Taizhou School of Clinical Medicine, Nanjing Medical University, Taizhou, Jiangsu, People's Republic of China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objective: To identify risk factors for recurrent lumbar disc herniation (rLDH) after percutaneous endoscopic lumbar discectomy (PELD) and to develop and internally validate a nomogram. Methods: This retrospective, single-center study included 607 patients who underwent PELD between January 2018 and December 2023. Thirty candidate predictors were collected. Predictor selection was performed using least absolute shrinkage and selection operator (LASSO) regression, followed by multivariable logistic regression. A nomogram was constructed in accordance with the Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis (TRIPOD) recommendations. Discrimination was assessed using the area under the receiver operating characteristic curve (AUC); for a binary outcome, the concordance index (C-index) is numerically equivalent to the AUC and was therefore reported for internal validation. Calibration was evaluated using the Hosmer-Lemeshow test and calibration curves. Internal validation was conducted using bootstrap resampling (1,000 iterations) and 10-fold cross-validation. Decision curve analysis (DCA) was applied to evaluate clinical utility. Results: During follow-up, 70 of 607 patients (11.5%) developed rLDH. Seven independent predictors were identified: postoperative activity, body mass index (BMI), smoking, ligamentum flavum (LF) thickness, sagittal range of motion (sROM), Modic change, and Pfirrmann grade. The nomogram achieved an AUC of 0.793 (95% CI: 0.736-0.850) and good calibration (Hosmer-Lemeshow P = 0.668). Internal validation showed a C-index of 0.763 (95% CI: 0.682-0.844) in bootstrap resampling and 0.775 in 10-fold cross-validation. The calibration curve showed close alignment with the ideal curve. DCA demonstrated favorable clinical utility of the model. Conclusion: This internally validated nomogram integrates clinical and imaging predictors to provide individualized rLDH risk prediction after PELD. It may assist in identifying patients at higher risk of recurrence who could benefit from closer postoperative surveillance and individualized decision-making. External validation is warranted before broad clinical implementation.

Indexed as

nomogram prediction modelpercutaneous endoscopic lumbar discectomyrecurrent lumbar disc herniationrisk factorTRIPOD guideline

Identifiers

PMID41858414
PMCPMC12996042

What Socratic holds

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LicenceCC BY-NC
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.