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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The aim of this study was to evaluate the performance and safety of a new hernia blocking system (HBS), implanted after a limited discectomy, to prevent recurrence of lumbar disc herniation. ⋯ The implantation of an HBS is a feasible and safe procedure that prevents early disc herniation recurrence in patients at high risk of reherniation.
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The SORG-MLA was developed to predict 90-day and 1-year postoperative survival in patients with spinal metastatic disease who underwent surgery between 2000 and 2016. Due to the constant changes in treatment methods, it is essential to perform temporal validation with a recent patient population. Therefore, the purpose of this study was to validate the Skeletal Oncology Research Group machine learning algorithms (SORG-MLA) using a contemporary patient cohort. ⋯ In spite of recent progress in treating spinal metastases, SORG-MLA for survival in patients with spinal metastatic disease continued to perform well on temporal validation. However, updating the models using a contemporary patient cohort and stratifying by primary tumor could further improve the performance.
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Cauda Equina Syndrome (CES) is a rare surgical emergency. The implications for loss of quality of life through delayed management are high, though no clinical symptom is pathognomonic in its diagnosis. We describe how machine learning based algorithms can be used in triaging patients with suspected CES (CES-S). ⋯ With our dataset, the trained algorithm demonstrated the potential for safely reducing the number of emergency MRI scans by over 95%. Prior to the wide clinical application, large volume prospective data is needed for continuous training of the algorithm, in order to improve accuracy and confidence of prediction.
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The Minimal Clinically Important Change (MCIC) is used in conjunction with Patient-Reported Outcome Measures (PROMs) to determine the clinical relevance of changes in health status. MCIC measures a change within the same person or group over time. This study aims to evaluate the variability in computing MCIC for the Core Outcome Measure Index (COMI) using different methods. ⋯ MCIC calculation methods produce varying values, emphasizing careful method selection. Distribution-based methods likely measure minimal detectable change, while non-predictive anchor-based methods can yield high MCIC values due to group averaging. Predictive anchor-based methods offer more stable and clinically relevant MCIC values for improvement but are affected by prevalence and reliability corrections.
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To evaluate the influence of vertebral and disc wedging on the contribution of lumbar lordosis and the change of disc thickness before and after walking based on MRI. ⋯ Age and walking activity are the influencing factors of lumbar lordosis and disc thickening. Walking activity can significantly increase lumbar lordosis, and age is the main factor promoting lumbar disc thickening. DHL4-5 was the thickest lumbar intervertebral disc with the fastest intergroup thickening. Disc wedging contributes more to lumbar lordosis than vertebral wedging.