Predicting and Analysing of the Unfavourable Outcomes of Early Applicated Percutaneous Endoscopic Interlaminar Discectomy

Jul 6, 2026

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The study aims to predict and analyze unfavourable outcomes after early applicated percutaneous endoscopic interlaminar discectomy (PEID) for lumbar disc herniation (LDH). Data from 426 patients treated between June 2017 and October 2021 were combined with 17 additional features. Risk factors were selected using LASSO regression, and a nomogram prediction model was built and internally validated with 1000 bootstrap samples. Performance was evaluated by C-index, ROC, and calibration, and clinical utility assessed using DCA and CIC. Five predictors were identified and demonstrated good discriminative ability.

LanguageEnglish

CategoryResearch & Report

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Pages9

Reading Time23 min

Abstract

Introduction

Methods

Inclusion and exclusion criteria

European Spine Journal (2024) 33:906–914 [https://doi.org/10.1007/s00586-024-08141-9](https://doi.org/10.1007/s00586-024-08141-9) Predicting and analysing of the unfavourable outcomes of early applicated percutaneous endoscopic interlaminar discectomy for lumbar disc herniation: development and validation based nomogram Huiyu Huang1 · Min Yang2 · Zhaojun Fu1 · Haigang Hu3 · Chao Wu3,4 · Lun Tan3 Received: 13 September 2023 / Accepted: 13 January 2024 / Published online: 11 February 2024 © The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2024 Abstract Objective To predict and analyse the unfavourable outcomes of early applicated percutaneous endoscopic interlaminar discectomy for lumbar disc herniation. Methods Information of 426 patients treated by early applicated percutaneous endoscopic interlaminar discectomy (PEID) for lumbar disc herniation (LDH) at our hospital from June 2017 to October 2021 in addition to 17 other features was collected. The risk factors were selected by the least absolute shrinkage and selection operator method (LASSO) regression. Then, a prediction model (nomogram) was established to predict the unfavourable outcomes of using the risk factors selected from LASSO regression. Bootstrap (n = 1000) was used to perform the internal validation, and the performance of the model was assessed by the concordance index (C-index), receiver operating characteristic curve, and calibration curve. The decision curve analysis (DCA) and clinical impact curve (CIC) were used to assess the clinical utility of the model, respectively. Results Finally, 53 of 426 patients showed unfavourable outcomes. Five potential factors, Modic change, Calcification, Lumbar epidural steroid injection preoperative, Articular process hyperplasia and cohesion, and Laminoplasty technique, were selected according to the LASSO regression, that identified the predictors to establish nomogram model. Meanwhile, the C-index of the prediction nomogram was 0.847, the area under the receiver operating characteristic curve value was 0.847, and the interval bootstrapping (n = 1000) validation C-index was 0.809. The model has good practicability for clinics according to the DCA and CIC. Conclusion This nomogram model has good predictive performance and clinical practicability, which could provide a certain basis for predicting unfavourable outcomes of early applicated PEID for LDH. Keywords Percutaneous endoscopic interlaminar discectomy · Lumbar disc herniation · Nomogram · Unfavourable outcome * Huiyu Huang [huanghuiyu5030@163.com](huanghuiyu5030@163.com) 1 Emergency Department, Zigong Fourth People’s Hospital, Zigong, China 2 Neurology Department, Zigong First People’s Hospital, Zigong, China 3 Orthopaedic Center, Zigong Fourth People’s Hospital, Zigong, China 4 Digital Medical Center, Zigong Fourth People’s Hospital, Zigong, China Abbreviations PEID Percutaneous endoscopic interlaminar discectomy LDH Lumbar disc herniation LASSO The least absolute shrinkage and selection operator method DCA The decision curve analysis CIC The clinical impact curve AUC The area under the receiver operating character istic curve BMI Body mass index COD Course of disease OT Operation time LI Lumbar epidural steroid injection preoperative LT Laminoplasty technique PG Pfirrmann grade MC Modic change LDH Level of herniated disc HT Herniation type APHC Articular process hyperplasia and cohesion VAS Visual analogue scale Introduction Lumbar disc herniation (LDH) is a common type of spinal degenerative disease, and low back and leg pain are its main symptoms [1] . Surgical treatment is often required when the symptoms of low back and leg pain are not relieved after conservative treatment [2] . Due to the progress of minimally invasive surgery, percutaneous endoscopic interlaminar discectomy (PEID) has become more mature in the treatment of LDH [3] . Specifically, PE

FAQs

What was the goal of the study?

To predict and analyze unfavourable outcomes after early applicated PEID for lumbar disc herniation.

How were risk factors and the prediction model developed?

Risk factors were selected using LASSO regression from patient data with 17 additional features, and a nomogram model was established using the selected predictors.

How was the model validated and its performance assessed?

Internal validation used 1000 bootstrap resamples, and performance was evaluated with C-index, ROC/AUC, and calibration; clinical utility was assessed with decision curve analysis and clinical impact curve.

Jul 6, 2026

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