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  • Ovid Technologies (Wolters Kluwer Health)  (2)
  • Fujii, Kengo  (2)
  • Englisch  (2)
  • 2020-2024  (2)
Materialart
Verlag/Herausgeber
  • Ovid Technologies (Wolters Kluwer Health)  (2)
Sprache
  • Englisch  (2)
Erscheinungszeitraum
  • 2020-2024  (2)
Jahr
  • 1
    In: Spine, Ovid Technologies (Wolters Kluwer Health), Vol. 46, No. 24 ( 2021-12-15), p. 1683-1689
    Kurzfassung: A retrospective analysis of prospectively collected data. Objective. This study aimed to create a prognostic model for surgical outcomes in patients with cervical ossification of the posterior longitudinal ligament (OPLL) using machine learning (ML). Summary of Background Data. Determining surgical outcomes helps surgeons provide prognostic information to patients and manage their expectations. ML is a mathematical model that finds patterns from a large sample of data and makes predictions outperforming traditional statistical methods. Methods. Of 478 patients, 397 and 370 patients had complete follow-up information at 1 and 2 years, respectively, and were included in the analysis. A minimal clinically important difference (MCID) was defined as an acquired Japanese Orthopedic Association (JOA) score of ≥2.5 points, after which a ML model that predicts whether MCID can be achieved 1 and 2 years after surgery was created. Patient background, clinical symptoms, and imaging findings were used as variables for analysis. The ML model was created using LightGBM, XGBoost, random forest, and logistic regression, after which the accuracy and area under the receiver-operating characteristic curve (AUC) were calculated. Results. The mean JOA score was 10.3 preoperatively, 13.4 at 1 year after surgery, and 13.5 at 2 years after surgery. XGBoost showed the highest AUC (0.72) and high accuracy (67.8) for predicting MCID at 1 year, whereas random forest had the highest AUC (0.75) and accuracy (69.6) for predicting MCID at 2 years. Among the included features, total preoperative JOA score, duration of symptoms, body weight, sensory function of the lower extremity sub-score of the JOA, and age were identified as having the most significance in most of ML models. Conclusion. Constructing a prognostic ML model for surgical outcomes in patients with OPLL is feasible, suggesting the potential application of ML for predictive models of spinal surgery. Level of Evidence: 4
    Materialart: Online-Ressource
    ISSN: 0362-2436 , 1528-1159
    Sprache: Englisch
    Verlag: Ovid Technologies (Wolters Kluwer Health)
    Publikationsdatum: 2021
    ZDB Id: 2002195-1
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 2
    In: Clinical Spine Surgery: A Spine Publication, Ovid Technologies (Wolters Kluwer Health), Vol. 34, No. 4 ( 2021-05), p. E223-E228
    Kurzfassung: Retrospective cohort study. Objective: To clarify the poor patient satisfaction after lumbar spinal surgery in elderly patients. Summary of Background Data: As the global population continues to age, it is important to consider the surgical outcome and patient satisfaction in the elderly. No studies have assessed patient satisfaction in elderly patients undergoing surgical treatment and risk factors for poor satisfaction in elderly patients after lumbar spinal surgery. Materials and Methods: A retrospective multicenter survey was performed in 169 patients aged above 80 years who underwent lumbar spinal surgery. Patients were followed up for at least 1 year after surgery. We assessed patient satisfaction from the results of surgery by using a newly developed patient questionnaire. Patients were assessed by demographic data, surgical procedures, complications, reoperation rate, pain improvement, and risk factors for poor patient satisfaction with surgery for lumbar spinal disease. Results: In total, 131 patients (77.5%, G-group) were satisfied and 38 patients (22.5%, P-group) were dissatisfied with surgery. The 2 groups did not differ significantly in baseline characteristics and surgical data. Postoperative visual analog scale score for low back pain and leg pain were significantly higher in the P-group than in the G-group (low back pain: G-group, 1.7±1.9 vs. P-group, 5.2±2.5, P 〈 0.001; leg pain: G-group, 1.4±2.0 vs. P-group, 5.5±2.6, P 〈 0.001). Multivariate regression analysis revealed that postoperative vertebral fracture ( P =0.049; odds ratio, 3.096; 95% confidence interval, 1.004–9.547) and reoperation ( P =0.025; odds ratio, 5.692; 95% confidence interval, 1.250–25.913) were significantly associated with the patient satisfaction after lumbar spinal surgery. Conclusions: Postoperative vertebral fracture and reoperation were found to be risk factors for poor patient satisfaction after lumbar spinal surgery in elderly patients, which suggests a need for careful treatment of osteoporosis in addition to careful determination of surgical indication and procedure in elderly patients. Level of Evidence: Level III.
    Materialart: Online-Ressource
    ISSN: 2380-0186
    Sprache: Englisch
    Verlag: Ovid Technologies (Wolters Kluwer Health)
    Publikationsdatum: 2021
    ZDB Id: 2849652-8
    Standort Signatur Einschränkungen Verfügbarkeit
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