{
  "abstract": "Background/Objectives: This study was conducted to develop and internally validate a nomogram that predicts postoperative ambulatory function in patients with metastatic epidural spinal cord compression (MESCC) undergoing decompressive surgery. Methods: Of 352 patients who underwent surgery for metastatic spinal cancer at a single tertiary center between 2014 and 2021, 97 with MESCC (Bilsky grade 2-3) and preoperative neurological deficits (ASIA grade D or worse) were included in this retrospective study. Binary logistic regression was used to identify candidate predictors of 3-month postoperative ambulatory status in the full cohort (p < 0.10 in univariable analysis), which were then entered into a multivariable logistic regression model and incorporated into a nomogram using the rms package in R. Model discrimination and calibration were internally validated using Harrell's bootstrap optimism-correction method with 1000 resamples. Results: Postoperative ambulation was regained in 24 patients (24.7%). Four variables met the prespecified threshold (p < 0.10) for inclusion in the nomogram: preoperative motor grade (OR 2.48; 95% CI 1.41-4.34; p = 0.002), symptom onset-to-operation interval (OR 0.81; 95% CI 0.62-1.04; p = 0.098), preoperative KPS (OR 1.04; 95% CI 1.00-1.07; p = 0.070), and age (OR 0.97; 95% CI 0.93-1.01; p = 0.087); in the multivariable model, only preoperative motor grade and symptom onset-to-operation interval were independently associated with ambulatory recovery (p < 0.05). The nomogram achieved an apparent AUC of 0.827 (optimism-corrected, 0.800) and acceptable-to-good calibration (optimism-corrected calibration slope, 0.848; intercept, -0.088). At the Youden-optimal threshold, apparent (optimism-corrected) sensitivity, specificity, and F1 score were 79.2% (74.5%), 78.1% (76.7%), and 64.4% (60.6%), respectively. Conclusions: The nomogram demonstrated acceptable discrimination and good calibration for predicting postoperative ambulation in patients with MESCC. This tool may support individualized surgical decision-making and patient counseling. External validation is required before routine clinical use.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Spine Care, King Abdullah Medical City, Makkah 24246, Saudi Arabia.",
    "Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 6,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Ibrahim S Alayed"
    },
    {
      "affs": [
        1
      ],
      "name": "Sehan Park"
    },
    {
      "affs": [
        1
      ],
      "name": "Dong-Ho Lee"
    },
    {
      "affs": [
        1
      ],
      "name": "Chang Ju Hwang"
    },
    {
      "affs": [
        1
      ],
      "name": "Sung Tan Cho"
    },
    {
      "affs": [
        1
      ],
      "name": "Jae Hwan Cho",
      "orcid": "0000-0002-1178-9778"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/e16bnrj6gmz5d.bib",
  "cited_by": 0,
  "doi": "10.3390/jcm15197459",
  "fulltext_url": "https://europepmc.org/articles/PMC13666026",
  "id": "e16bnrj6gmz5d",
  "issns": [
    "2077-0383"
  ],
  "landing_url": "https://europepmc.org/article/MED/42881920",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2746|Management of metastatic bone disease"
    ]
  ],
  "openalex": "W7214315168",
  "pdf_url": "https://europepmc.org/articles/PMC13666026?pdf=render",
  "pmcid": "PMC13666026",
  "pmid": "42881920",
  "published": "2026-09-25",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/e16bnrj6gmz5d.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:16Z",
      "native_id": "MED:42881920",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42881920"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2746|Management of metastatic bone disease",
      "subfield": "surgery"
    }
  ],
  "title": "Prediction of Postoperative Ambulatory Function Using Nomogram in Patients with Metastatic Epidural Spinal Cord Compression.",
  "title_text": "Prediction of Postoperative Ambulatory Function Using Nomogram in Patients with Metastatic Epidural Spinal Cord Compression.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:19:16Z",
  "url": "https://research.draconitic.com/paper/e16bnrj6gmz5d",
  "venue": "Journal of clinical medicine",
  "versions": []
}