ArticleFrontiers in medicine2026
Development and internal validation of a nomogram for predicting short-term functional improvement after pharmacological treatment in severe symptomatic lumbar disk herniation.
Article in Frontiers in medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Lumbar disk herniation (LDH) is an important cause of low back pain and functional impairment. For patients with severe LDH who are not immediate candidates for surgery or prefer to delay surgery, pharmacological treatment remains a major therapeutic option; however, short-term treatment responses vary substantially among individuals. At present, individualized tools for predicting short-term functional improvement after pharmacological treatment are lacking. Therefore, this study aimed to develop and internally validate a nomogram to predict 14-day improvement in the Oswestry Disability Index (ODI) in patients with severe LDH following pharmacological treatment. Methods: A total of 199 patients with MRI-confirmed severe LDH from 13 centers were included. All patients received 14 days of pharmacological treatment [Chinese patent medicine (CPM) vs. non-steroidal anti-inflammatory drugs (NSAIDs)]. The primary outcome was change in ODI at day 14. Candidate predictors were reduced using AIC-guided multivariable modeling, and a nomogram was developed from the final model. Secondary exploratory logistic analyses were performed using clinically relevant ODI improvement thresholds (>10, >20, and >30 points), with >10 points corresponding to the minimal clinically important difference (MCID). Internal validation was performed using bootstrap resampling. Results: The optimal linear prediction model included six key variables: treatment group, sex, alkaline phosphatase (ALP), angular instability, degree of disk herniation (DDH), and hypertrophy of the ligamentum flavum (HLF). In the primary linear model, CPM treatment, female sex, higher ALP levels, and DDH-protrusion were significantly associated with lower ODI improvement (all Conclusion: This internally validated nomogram may help estimate short-term functional improvement after pharmacological treatment in severe LDH and may assist pre-treatment risk stratification. However, given the short follow-up, limited sample size, and absence of external validation, the model should be considered preliminary and requires further validation before routine clinical use.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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 OpenQuestion graph.