ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2026
Percutaneous endoscopic interlaminar discectomy in patients with lumbar disc herniation: risk factors and thresholds for adverse outcomes.
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, 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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Abstract
backgroundPercutaneous endoscopic interlaminar discectomy (PEID) is a common surgical technique for lumbar disc herniation (LDH), but the risk factors for adverse outcomes remain controversial. This study aims to develop and validate a predictive model based on machine learning algorithms to identify key clinical indicators influencing adverse outcomes after PEID.
methodsThis retrospective study included 414 LDH patients who underwent single-level PEID between October 2018 and June 2024. Data were divided into training (n = 290) and validation (n = 124) sets. Six machine learning algorithms were used for feature selection, identifying core indicators. Models were constructed based on these indicators and evaluated for predictive performance.
resultFive core indicators were identified: Modic Changes (MC), Basal Width Of The Herniated Disc (BWHD), Body Mass Index (BMI), Ratio Of Disc Herniation (RDH), and Interspinous Ligament Injury (ILI). The XGB model performed best, with an AUC of 0.809 in the training set and 0.718 in the validation set. Risk thresholds for BWHD, BMI, and RDH were 1.7 mm, 23.3 kg/m², and 37.2%, respectively.
conclusionMC, ILI, BWHD, BMI, and RDH are risk factors for postoperative adverse outcomes in PEID patients. The model provides useful clinical guidance, with validated risk thresholds for key indicators.
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