A multidimensional nomogram combining clinical factors and imaging features to predict 1-year recurrence of low back pain with or without radicular pain after spinal manipulation/mobilization.

Background: In this retrospective study, we aimed to develop a nomogram to predict recurrence during a 1-year period of spinal manipulation/mobilization (SM/M) in patients with low back pain (LBP) with greater pain intensity, more severe comorbid conditions, or a neuropathic component. Methods: A to...

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Publicado en:Chiropractic & Manual Therapies Vol. 31; no. 1; pp. 1 - 13
Autores principales: Sun, Dai, Liu, Yang-yang, Luo, Dan, Wu, Ye-qi, Yan, Zhi-qiang, Liang, Yun-qi, Huang, Xue-yan, Lin, Jia-long, Luo, Hua-song, Wang, Rui
Formato: research tables/charts Journal Article
Publicado: BioMed Central 8/10/2023
Acceso en línea:Ver este registro en EBSCOhost
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        atl: A multidimensional nomogram combining clinical factors and imaging features to predict 1-year recurrence of low back pain with or without radicular pain after spinal manipulation/mobilization.
      aug:
        au:
          Sun, Dai
          Liu, Yang-yang
          Luo, Dan
          Wu, Ye-qi
          Yan, Zhi-qiang
          Liang, Yun-qi
          Huang, Xue-yan
          Lin, Jia-long
          Luo, Hua-song
          Wang, Rui
        affil: Department of Massage, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, China
      sug:
        subj:
          Models, Statistical
          Recurrence
          Manipulation, Orthopedic
          Low Back Pain Therapy
          Pain Measurement
          Comorbidity
          Human
          Retrospective Design
          Cox Proportional Hazards Model
          Regression
          Magnetic Resonance Imaging
          Kaplan-Meier Estimator
          ROC Curve
          Checklists
          Data Analysis Software
          Chi Square Test
          Fisher's Exact Test
          Scales
          Funding Source
      ab: Background: In this retrospective study, we aimed to develop a nomogram to predict recurrence during a 1-year period of spinal manipulation/mobilization (SM/M) in patients with low back pain (LBP) with greater pain intensity, more severe comorbid conditions, or a neuropathic component. Methods: A total of 786 consecutive patients with LBP treated with SM/M as primary therapy were divided into training (n = 545) and validation (n = 241) sets. Cox regression analyses were used to assess the relative value of clinical factors and lumbar magnetic resonance imaging features associated with recurrence during the 1-year period. Predictors of recurrence with significant differences were used to construct a nomogram in the training set. We evaluated the performance of the model on the training and validation sets to determine its discriminative ability, calibration, and clinical utility. The prognostic value of the nomogram for predicting recurrence was assessed using Kaplan–Meier analysis and time-dependent receiver operating characteristic analyses. Results: A nomogram comprising hospitalization time, previous history of LBP, disease duration, lumbar range of motion, lower extremity tendon reflex, muscle strength, ratio of herniation to uncompressed dural sac area, and Pfirrmann classification was established for recurrence during a 1-year period after SM/M in patients with LBP. Favorable calibration and discrimination were observed in the nomogram training and validation sets (C-index 0.753 and 0.779, respectively). Decision curve analysis confirmed the clinical utility of the nomogram. Over a 1-year period, the nomogram showed satisfactory performance in predicting recurrence in LBP after SM/M. Conclusion: We established and validated a novel nomogram that can accurately predict a patient's risk of LBP recurrence following SM/M. This realistic prognostic model may aid doctors and therapists in their decision-making process and strategy optimization for non-surgical treatment of LBP using SM/M.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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