Analysis of Factors Associated with Ambulatory Function Following Percutaneous Endoscopic Lumbar Discectomy in Patients with L5-S1 Foraminal Stenosis.

Abstract

To investigate the factors influencing postoperative ambulatory function in patients with L5-S1 foraminal stenosis who underwent percutaneous endoscopic lumbar discectomy (PELD). This retrospective study was conducted on the clinical data of 146 patients with L5-S1 foraminal stenosis who underwent PELD at the General Hospital of Ningxia Medical University between January 2023 and February 2024. The 6-minute walk distance (6MWD) test evaluated ambulatory function at 3 months postoperatively. Demographic characteristics, clinical features, comorbidities, and surgery-related parameters were collected. Univariate analysis and Pearson correlation tests were performed using the 6MWD at 3 months as the dependent variable. Variables with statistical significance (P < 0.05) were then entered into a multivariate linear regression analysis to identify independent predictors and establish a predictive model. A total of 146 patients with L5-S1 foraminal stenosis were retrospectively analyzed. Univariate analysis showed that educational level had a significant impact on the 6MWD at 3 months postoperatively (P < 0.001). Pearson correlation analysis revealed that postoperative 6MWD was significantly correlated with age, body weight, lower limb pain visual analog scale score, preoperative 6MWD (assessed 1 day before surgery), and preoperative low back pain visual analog scale score (P < 0.05). Multivariate linear regression analysis identified preoperative 6MWD, age, and body weight as independent predictors of postoperative 6MWD (P < 0.05). The predictive equation derived from the regression model was as follows: postoperative 6MWD at 3 months = 163.498 + (0.885 × preoperative 6MWD) - (0.515 × age) - (0.775 × body weight). Multiple factors influence ambulatory function following PELD in patients with L5-S1 foraminal stenosis. A better preoperative 6MWD, younger age, and lower body weight were associated with improved postoperative 6MWD outcomes.