European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
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Large language models (LLM) have recently attracted attention because of their enormous performance. Based on artificial intelligence, LLM enable dialogic communication using quasi-natural language that approximates the quality of human communication. Thus, LLM could play an important role for patients to become informed. To evaluate the validity of an LLM in providing medical information, we used one of the first high-performance LLM (ChatGPT) on the clinical example of acute lumbar disc herniation (LDH). ⋯ With the incipient use of artificial intelligence in communication, LLM will certainly become increasingly important to patients. Even if LLM are unlikely to play a role in clinical communication between physicians and patients at the moment, the opportunities-but also the risks-of this novel technology should be alertly monitored.
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Deep learning (DL) algorithms can be used for automated analysis of medical imaging. The aim of this study was to assess the accuracy of an innovative, fully automated DL algorithm for analysis of sagittal balance in adult spinal deformity (ASD). ⋯ This is the first study evaluating a complete automated DL algorithm for analysis of sagittal balance with high accuracy for all evaluated parameters. The excellent accuracy in the challenging pathology of ASD with long construct instrumentation demonstrates the eligibility and possibility for implementation in clinical routine.
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Radiation-free systems based on dorsal surface topography can potentially represent an alternative to radiographic examination for early screening of scoliosis, based on the ability of recognizing the presence of deformity or classifying its severity. This study aims to assess the effectiveness of a deep learning model based on convolutional neural networks in directly predicting the Cobb angle from rasterstereographic images of the back surface in subjects with adolescent idiopathic scoliosis. ⋯ Despite some improvement over previous approaches that relied on spine shape reconstruction, the performance of the present fully automatic application is below that of radiographic evaluation performed by human operators. The study confirms that rasterstereography cannot be considered a valid non-invasive alternative to radiographic examination for clinical purposes.
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Recently, enhanced recovery after surgery (ERAS) protocols have attracted attention; they emphasize on avoiding intraoperative hypothermia while performing lumbar fusion surgery. However, none of the studies have reported the protocol for determining the temperature of saline irrigation during biportal endoscopic spine surgery (BESS) procedure. This study evaluated the effectiveness of warm saline irrigation during BESS in acute postoperative pain and inflammatory reactions. ⋯ Using warm saline irrigation during BESS is beneficial for early recovery after surgery, as it is associated with reduced postoperative pain and complication rates.
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To provide lumbar spine anatomical parameters relevant to the UBE technique and explore their intraoperative application. ⋯ Referring to the drill diameter during surgery can mark the extent of laminotomy. The characteristics of vertebral plate angles at different lumbar levels can provide references for preoperative incision design.