{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T14:16:22Z","timestamp":1785161782387,"version":"3.55.0"},"reference-count":40,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T00:00:00Z","timestamp":1785110400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"\n Background<\/jats:title>\n To identify the independent risk factors for postoperative recurrence following unilateral biportal endoscopic discectomy (UBED) for lumbar disc herniation (LDH), and to develop and validate a recurrence risk prediction model.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To analyze the risk factors contributing to postoperative recurrence in patients with LDH treated by UBED, and to construct and validate a predictive nomogram for recurrence risk after UBED.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n A total of 257 patients with single-level LDH who underwent UBED were retrospectively enrolled, among whom 24 presented postoperative recurrence, corresponding to a recurrence rate of 9.34%. The cohort was split into a training set (\n n<\/jats:italic>\n \u2009=\u2009179) and a validation set (\n n<\/jats:italic>\n \u2009=\u200978) at a 7:3 ratio. Thirty clinical and radiological parameters were collected. Least Absolute Shrinkage and Selection Operator (LASSO) regression combined with multivariate logistic regression was applied to screen independent risk factors, and a nomogram prediction model was subsequently established. Model performance was assessed via receiver operating characteristic (ROC) curves, Hosmer-Lemeshow (H-L) test, calibration curves, and decision curve analysis (DCA).\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Twelve independent risk factors for postoperative recurrence were identified. The area under the ROC curve (AUC) reached 0.976 in the training set and 0.953 in the validation set. The P values of the H-L test were both &gt;0.05 in the two datasets, indicating favorable model calibration. The model yielded significant clinical net benefit within threshold probabilities of 0\u20130.92 (training set) and 0\u20130.89 (validation set).<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n The established nomogram incorporating 12 clinical and radiological variables exhibits satisfactory discrimination and calibration for predicting recurrence after UBED. It serves as a quantitative tool for rapid identification of patients at high recurrence risk in clinical practice. Nevertheless, limitations including single-center retrospective design, relatively small sample size, and an events-per-variable (EPV) ratio of approximately 2:1 (far below the recommended threshold) introduce potential overfitting and limited generalizability. This model is only applicable for preliminary screening of high-risk individuals and preoperative patient counseling, rather than acting as the sole basis for clinical decision-making. Multicenter, large-sample prospective cohort studies are warranted for further external validation and model refinement in the future.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fsurg.2026.1778866","type":"journal-article","created":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T13:37:31Z","timestamp":1785159451000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Development and validation of a clinical predictive model for the risk of recurrence after unilateral biportal endoscopic diskectomy"],"prefix":"10.3389","volume":"13","author":[{"given":"Zhen","family":"Yi","sequence":"first","affiliation":[{"name":"Department of Traditional Chinese Medicine, Foshan No. 5 People's Hospital","place":["Foshan, Guangdong"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Changhe","family":"Liao","sequence":"additional","affiliation":[{"name":"Guangzhou Panyu District Traditional Chinese Medicine Hospital, 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