Coronal Three-Dimensional Magnetic Resonance Imaging for Improving Diagnostic Accuracy for Posterior Ligamentous Complex Disruption In a Goat Spine Injury Model

Zhu, Xuee; Wang, Jichen; Zhou, Dan; Chen, Feng; Zhang, Dong; Yu, Hanxiao

doi:10.3348/kjr.2018.0632

Cited by 1 publication

(1 citation statement)

References 27 publications

(73 reference statements)

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“…This system has a total score of 10, and patients with a score of less than 3 are considered to be the target population for conservative treatment. However, given the controversy over the reproducibility and feasibility of magnetic resonance imaging (MRI) assessment criteria, further clarification of the role of PLC integrity in thoracolumbar spine fractures is still necessary [ 10 – 12 ]. The new AO TL injury classification system introduced by Vaccaro et al provides spine surgeons with a convenient and reproducible classification system that includes morphological classification of fractures, neurological status grading, and specific fracture modifiers [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

Predictors of adverse events after percutaneous pedicle screws fixation in patients with single-segment thoracolumbar burst fractures

Dong

Tang

et al. 2022

BMC Musculoskelet Disord

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Background Percutaneous pedicle screw fixation (PPSF) is the primary approach for single-segment thoracolumbar burst fractures (TLBF). The healing angle at the thoracolumbar junction is one of the most significant criteria for evaluating the efficacy of PPSF. Therefore, the purpose of this study was to analyze the predictors associated with the poor postoperative alignment of the thoracolumbar region from routine variables using a support vector machine (SVM) model. Methods We retrospectively analyzed patients with TLBF operated at our academic institute between March 1, 2014 and December 31, 2019. Stepwise logistic regression analysis was performed to assess potential statistical differences between all clinical and radiological variables and the adverse events. Based on multivariate logistic results, a series of independent risk factors were fed into the SVM model. Meanwhile, the feature importance of radiologic outcome for each parameter was explored. The predictive performance of the SVM classifier was evaluated using the area under the receiver operating characteristic curve (AUC), accuracy (ACC) and confusion matrices with 10-fold cross-validation, respectively. Results In the recruited 150 TLBFs, unfavorable radiological outcomes were observed in 53 patients (35.33%). The relationship between osteoporosis (p = 0.036), preoperative Cobb angle (p = 0.001), immediate postoperative Cobb angle (p = 0.029), surgically corrected Cobb angle (p = 0.001), intervertebral disc injury (Score 2 p = 0.001, Score 3 p = 0.001), interpedicular distance (IPD) (p = 0.001), vertebral body compression rate (VBCR) (p = 0.010) and adverse events was confirmed by univariate regression. Thereafter, independent risk factors including preoperative Cobb angle, the disc status and IPD and independent protective factors surgical correction angle were identified by multivariable logistic regression. The established SVM classifier demonstrated favorable predictive performance with the best AUC = 0.93, average AUC = 0.88, and average ACC = 0.87. The variables associated with radiological outcomes, in order of correlation strength, were intervertebral disc injury (42%), surgically corrected Cobb angle (25%), preoperative Cobb angle (18%), and IPD (15%). The confusion matrix reveals the classification results of the discriminant analysis. Conclusions Critical radiographic indicators and surgical purposes were confirmed to be associated with an unfavorable radiographic outcome of TLBF. This SVM model demonstrated good predictive ability for endpoints in terms of adverse events in patients after PPSF surgery.

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Section: Introductionmentioning

confidence: 99%