• Takafumi Koyama, Koji Fujita, Masaru Watanabe, Kaho Kato, Toru Sasaki, Toshitaka Yoshii, Akimoto Nimura, Yuta Sugiura, Hideo Saito, and Atsushi Okawa.
• Department of Orthopaedic and Spinal Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Japan.
• Spine. 2022 Jan 15; 47 (2): 163-171.

Study DesignCross-sectional study.ObjectiveTo develop a binary classification model for cervical myelopathy (CM) screening based on a machine learning algorithm using Leap Motion (Leap Motion, San Francisco, CA), a novel noncontact sensor device.Summary Of Background DataProgress of CM symptoms are gradual and cannot be easily identified by the patients themselves. Therefore, screening methods should be developed for patients of CM before deterioration of myelopathy. Although some studies have been conducted to objectively evaluate hand movements specific to myelopathy using cameras or wearable sensors, their methods are unsuitable for simple screening outside hospitals because of the difficulty in obtaining and installing their equipment and the long examination time.MethodsIn total, 50 and 28 participants in the CM and control groups were recruited, respectively. The diagnosis of CM was made by spine surgeons. We developed a desktop system using Leap Motion that recorded 35 parameters of fingertip movements while participants gripped and released their fingers as rapidly as possible. A support vector machine was used to develop the binary classification model, and a multiple linear regression analysis was performed to create regression models to estimate the total Japanese Orthopaedic Association (JOA) score and the JOA score of the motor function of the upper extremity (MU-JOA score).ResultsThe binary classification model indexes were as follows: sensitivity, 84.0%; specificity, 60.7%; accuracy, 75.6%; area under the curve, 0.85. The Spearman rank correlation coefficient between the estimated score and the total JOA score was 0.44 and that between the estimated score and the MU-JOA score was 0.51.ConclusionOur binary classification model using a machine learning algorithm and Leap Motion could classify CM with high sensitivity and would be useful for CM screening in daily life before consulting doctors and telemedicine.Level of Evidence: 3.Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.

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