Real-world study for identifying the predictive factors of surgical intervention and the value of magnetic resonance imaging in patients with low back pain

Wang, Hui; Liu, Chang; Meng, Zhou; Zhou, Wenxian; Chen, Tao; Zhang, Kai; Wu, Ai-Min

doi:10.21037/qims-21-584

Cited by 3 publications

(2 citation statements)

References 29 publications

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“…By conducting a literature review and considering the study objectives, 15 predictors were screened. [19][20][21][22] The basic characteristics and imaging findings of the patients were prospectively collected from each hospital care system. Potential predictive variables obtained at hospital admission included age, sex, body mass index (BMI), smoking (defined as daily consumption of more than 1 cigarette for a continuous or cumulative period of 6 months, persisting until 1 week before treatment), duration, Oswestry Disability Index (ODI) at admission, degree of positive straight leg raise test, lower limb muscle strength, lower limb sensation, disc herniation level and type, lumbar spondylolisthesis, lumbar spinal stenosis, and lumbar lateral recess stenosis.…”

Section: Potential Predictive Variablesmentioning

confidence: 99%

Estimating surgical probability: Development and validation of a prognostic model for patients with lumbar disc herniation treated with acupuncture

Chen,

Lv,

et al. 2023

Medicine

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Lumbar disc herniation (LDH) is a common cause of pain in the lumbar spine and legs. While acupuncture has become the primary conservative treatment for LDH, some patients experience treatment failure and require surgery, causing substantial concern for clinicians. We developed an effective personalized clinical prediction model to identify the independent risk factors associated with acupuncture failure in patients with LDH. Our model aimed to predict the probability of surgery within 6 months of acupuncture failure in patients with LDH. A total of 738 patients with LDH who underwent acupuncture at 4 Chinese hospitals between January 2019 and October 2021 were selected. The patients were divided into training (n = 496) and validation (n = 242) cohorts. Seven predictive variables, including smoking, Oswestry Disability Index (ODI) score, lower-limb herniation, disc herniation type, lumbar spinal stenosis, lumbar lateral recess stenosis, and acupuncture frequency, were selected as risk factors using least absolute shrinkage and selection operato (LASSO) regression. A prediction model was developed using multivariate logistic regression analysis and a nomogram was constructed. The model exhibited good discrimination, with an area under the ROC curve (AUC) of 0.903 for the development cohort and 0.899 for the validation cohort. The Hosmer-Lemeshow goodness-of-fit test was a good fit for both cohorts (P = .956 for the development cohort; P = .513 for the validation cohort). Decision curve analysis (DCA) demonstrated that the threshold probabilities for the 2 cohorts ranged from > 4% and 5–95%, respectively. Therefore, the prediction model had a good net benefit. The nomogram established in this study, incorporating 7 risk factors, demonstrated a good predictive ability. It could predict acupuncture failure in LDH patients and the risk of surgery within 6 months, enabling physicians to conduct individualized treatment measures.

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Section: Potential Predictive Variablesmentioning

confidence: 99%

Estimating surgical probability: Development and validation of a prognostic model for patients with lumbar disc herniation treated with acupuncture

Chen,

Lv,

et al. 2023

Medicine

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“…The prevalence of CLBP among adults has been reported to be as high as 20.3% ( 2 ). It increases linearly from the third decade of life ( 3 ), and 80% of the population will have at least 1 episode of CLBP in their lifetime ( 4 ).…”

Section: Introductionmentioning

confidence: 99%

Functional magnetic resonance imaging reveals dysfunction of the paraspinal muscles in patients with chronic low back pain: a cross-sectional study

Chen¹,

Huang²,

Zhang³

et al. 2023

Quant Imaging Med Surg

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Background: Patients with chronic low back pain (CLBP) undergo structural changes of the paraspinal muscles; however, it is unclear if functional changes also occur. This study aimed to examine the metabolic and perfusion function changes in the paraspinal muscles of patients with CLBP as indirectly reflected by blood oxygen level-dependent (BOLD) imaging and T2 mapping.Methods: All participants were consecutively enrolled at our local hospital from December 2019 to November 2020. Patients were diagnosed with CLBP in the outpatient clinic, and asymptomatic participants were considered to be those with no CLBP or other diseases. This study was not registered on a clinical trial platform. Participants underwent BOLD imaging and T2 mapping scans at the L4-S1 disc level. The effective transverse relaxation rate (R2* values) and transverse relaxation time (T2 values) of the paraspinal muscles were measured on the central plane of the L4/5 and L5/S1 intervertebral discs. Finally, the independent samples t-test was used to assess the differences in R2* and T2 values between the 2 groups, while Pearson correlation analysis was used to determine their correlation with age.Results: A total of 60 patients with CLBP and 20 asymptomatic participants were enrolled. The paraspinal muscles of the CLBP group had higher total R2* values [46.7±2.9 vs.

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Predictive value of texture analysis on lumbar MRI in patients with chronic low back pain

Climent-Peris,

Martí-Bonmatí,

Rodríguez-Ortega

et al. 2023

Eur Spine J

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Real-world study for identifying the predictive factors of surgical intervention and the value of magnetic resonance imaging in patients with low back pain

Cited by 3 publications

References 29 publications

Estimating surgical probability: Development and validation of a prognostic model for patients with lumbar disc herniation treated with acupuncture

Estimating surgical probability: Development and validation of a prognostic model for patients with lumbar disc herniation treated with acupuncture

Functional magnetic resonance imaging reveals dysfunction of the paraspinal muscles in patients with chronic low back pain: a cross-sectional study

Predictive value of texture analysis on lumbar MRI in patients with chronic low back pain

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