ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2020
Development and temporal validation of a prognostic model for 1-year clinical outcome after decompression surgery for lumbar disc herniation.
Article in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed, 29 citations in OpenAlex.
- Poor predictive performance of early outcome models following lumbar disc herniation surgery.Bone & joint open · 2026Article
- Development and validation of a prognostic prediction model for lumbar-disc herniation based on machine learning and fusion of clinical text data and radiomic features.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026Article
- External validation of a prediction model for disability and pain after lumbar disc herniation surgery: a prospective international registry-based cohort study.Acta orthopaedica · 2025Article
- The Core Outcome Measures Index (COMI) comes of age: 18 years of efficient and effective patient-reported outcome measurement in the field of spinal disorders. Part 1. Development of the COMI, interpretation of scores, and use in research.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2025Review
- Radiomics based on MRI to predict recurrent L4-5 disc herniation after percutaneous endoscopic lumbar discectomy.BMC medical imaging · 2024Article
- How well can the clinician appraise the patient's perception of the severity and impact of their back problem?European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2024Article
- Development and temporal validation of clinical prediction models for 1-year disability and pain after lumbar decompressive surgery. The Norwich Lumbar Surgery Predictor (development version).European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2023Article
- Clinical and radiomics feature-based outcome analysis in lumbar disc herniation surgery.BMC musculoskeletal disorders · 2023Article
- Predicting patient-reported outcomes following lumbar spine surgery: development and external validation of multivariable prediction models.BMC musculoskeletal disorders · 2023Article
- Feasibility and Assessment of a Machine Learning-Based Predictive Model of Outcome After Lumbar Decompression Surgery.Global spine journal · 2022Article
- Prediction of outcome after spinal surgery-using The Dialogue Support based on the Swedish national quality register.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2022Article
- Application of a nomogram to radiomics labels in the treatment prediction scheme for lumbar disc herniation.BMC medical imaging · 2022Article
- Effect of BMI on the clinical outcome following microsurgical decompression in over-the-top technique: bi-centric study with an analysis of 744 patients.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2021Article
- Prediction Models in Degenerative Spine Surgery: A Systematic Review.Global spine journal · 2021Article
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeSurgeons need tools to provide individualised estimates of surgical outcomes and the uncertainty surrounding these, to convey realistic expectations to the patient. This study developed and validated prognostic models for patients undergoing surgical treatment of lumbar disc herniation, to predict outcomes 1 year after surgery, and implemented these models in an online prediction tool.
methodsUsing the data of 1244 patients from a large spine unit, LASSO and linear regression models were fitted with 90% upper prediction limits, to predict scores on the Core Outcome Measures Index, and back and leg pain. Candidate predictors included sociodemographic factors, baseline symptoms, medical history, and surgeon characteristics. Temporal validation was conducted on 364 more recent patients at the same unit, by examining the proportion of observed outcomes exceeding the threshold of the 90% upper prediction limit (UPL), and by calculating mean bias and other calibration measures.
resultsPoorer outcome was predicted by obesity, previous spine surgery, and having basic obligatory (rather than private) insurance. In the validation data, fewer than 12% of outcomes were above the 90% UPL. Calibration plots for the model validation showed values for mean bias < 0.5 score points and regression slopes close to 1.
conclusionWhile the model accuracy was good overall, the prediction intervals indicated considerable predictive uncertainty on the individual level. Implementation studies will assess the clinical usefulness of the online tool. Updating the models with additional predictors may improve the accuracy and precision of outcome predictions. These slides can be retrieved under Electronic Supplementary Material.
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