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
-
Retracted Publication
Prediction of patient's neurological recovery from cervical spinal cord injury through XGBoost learning approach.
Due to the diversity of patient characteristics, therapeutic approaches, and radiological findings, it can be challenging to predict outcomes based on neurological consequences accurately within cervical spinal cord injury (SCI) entities and based on machine learning (ML) technique. Accurate neurological outcomes prediction in the patients suffering with cervical spinal cord injury is challenging due to heterogeneity existing in patient characteristics and treatment strategies. Machine learning algorithms are proven technology for achieving greater prediction outcomes. ⋯ Thus, with the proposed XGBoost approach, the enhanced accuracy in reaching the outcome is 81.1%, and from other models such as decision tree (80%) and logistic regression (82%), in predicting outcomes of neurological improvements within cervical SCI patients. Considering the AUC, the XGBoost and decision tree valued with 0.867 and 0.787, whereas logistic regression showed 0.877. Therefore, the application of XGBoost for accurate prediction and decision-making in the categorization of pre-treatment in patients with cervical SCI has reached better development with this study.
-
Over the last years, the number of vertebral arthrodesis has been steadily increasing. The use of iliac crest bone autograft remains the "gold standard" for bone graft substitute in these procedures. However, this solution has some side effects, such as the problem of donor site morbidity indicating that there is a real need for adequate alternatives. This pilot study aimed to evaluate the usefulness of chitosan (Ch) porous 3D scaffolds incorporated with resolvin D1 (RvD1) as an alternative implant to iliac bone autograft. ⋯ These results demonstrate the potential of these scaffolds for bone tissue repair applications.
-
Review Meta Analysis
Comparison of clinical outcomes associated with spinal cord stimulation (SCS) or conventional medical management (CMM) for chronic pain: a systematic review and meta-analysis.
This study aims to evaluate the efficacy and safety of spinal cord stimulation (SCS) compared to conventional medical management (CMM) for patients diagnosed with chronic pain. Furthermore, the study seeks to compare the utilization of analgesics, as well as the long-term outcomes in terms of quality of life and functional capacity. ⋯ SCS is an effective treatment to relieve the pain level of chronic pain, decrease analgesic usage, and increase long-term quality of life and functional capacity.
-
To manufacture and test 3D printed novel design titanium spine rods with lower flexural modulus and stiffness compared to standard solid titanium rods for use in metastatic spine tumour surgery (MSTS) and osteoporosis. ⋯ By utilising novel design approach, we successfully generated a spine rod design portfolio with lower flexural modulus/stiffness profile and better CT/MR imaging compatibility for potential use in MSTS/other conditions such as osteoporosis. Thus, exploration of new rod designs in surgical application could enhance treatment outcome and improve quality of life for patients.
-
Review
Patient and surgical predictors of 3D correction in posterior spinal fusion: a systematic review.
Restoration of three-dimensional (3D) alignment is critical in correcting patients with adolescent idiopathic scoliosis using posterior spinal fusion (PSF). However, current studies mostly rely on 2D radiographs, resulting in inaccurate assessment of surgical correction and underlying predictive factors. While 3D reconstruction of biplanar radiographs is a reliable and accurate tool for quantifying spinal deformity, no study has reviewed the current literature on its use in evaluating surgical prognosis. ⋯ Rod contouring and UIV/LIV selection should be based on preoperative 3D TK in order to achieve normal postoperative alignment. Specifically, Lenke 1 patients with high-lying rotations should be fused distally at NV-1, while hypokyphotic patients with large lumbar curves and truncal shift should be fused at NV to improve lumbar alignment. Lenke 1C curves should be corrected using > 50% LIV rotation counterclockwise to the lumbar rotation. Further investigation should compare surgical correction between pedicle-screw and hybrid constructs using matched cohorts. DJK and overbending rods are potential predictors of postoperative alignment.