Prediction of Postoperative Ambulatory Function Using Nomogram in Patients with Metastatic Epidural Spinal Cord Compression

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.