A Nomogram for Predicting Poor Incision Healing after Interbody Fusion for Recurrent Lumbar Disc Herniation

Objective: To investigate the independent risk factors of poor incision healing (PIH) after interbody fusion for recurrent lumbar disc herniation (RLDH) and construct a nomogram prediction model. Methods: We conducted a retrospective analysis. Univariate analysis and multivariate logistic regression analysis were conducted to identify the independent risk factors of PIH. A nomogram model was established based on the independent risk factors. The receiver operating characteristic curve (ROC), calibration curve, and decision curve analysis (DCA) were used to evaluate the reliability and clinical values of the nomogram. Results: 131 patients were enrolled in this study and 15 patients suffered from PIH. Patients in the PIH group had longer postoperative hospital stays. Multivariate logistic regression analysis revealed that BMI, operative time ≥ 180 min, and postoperative albumin ≤ 35g/L were the independent risk factors of PIH. The nomogram model was constructed based on the independent risk factors. The area under the curve (AUC) of the ROC curve was 0.867 which indicated the model had excellent predictive performance. The calibration curve showed good agreement between predicted and actual risk values of PIH. The decision curve analysis suggested that the nomogram model had good clinical guidance values. Conclusions: This study suggested that BMI, operative time ≥ 180 min, and postoperative albumin ≤35g/L were the independent risk factors of PIH after interbody fusion for RLDH. The nomogram model effectively predicted the occurrence of postoperative PIH and had good clinical guidance values.