Spine surgeon versus AI algorithm full-length radiographic measurements: a validation study of complex adult spinal deformity patients

Haselhuhn, Jason J.; Soriano, Paul Brian O.; Grover, Priyanka; Dreischarf, Marcel; Odland, Kari; Hendrickson, Nathan R.; Jones, Kristen E.; Martin, Christopher T.; Sembrano, Jonathan N.; Polly, David W.

doi:10.1007/s43390-024-00825-y

Cited by 3 publications

(1 citation statement)

References 18 publications

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“…These specific time points were chosen to capture the dynamic changes in lumbar lordosis throughout the surgical process, from preoperative baseline to immediate postoperative status. The choice of measurement technique was based on its widespread use in clinical practice and its established reliability in assessing spinal alignment [ 16 , 17 , 18 ]. Additionally, the selected measurement points were consistent with standard protocols for evaluating lumbar lordosis in spinal surgery research [ 19 ].…”

Section: Methodsmentioning

confidence: 99%

Impact of Supine versus Prone Positioning on Segmental Lumbar Lordosis in Patients Undergoing ALIF Followed by PSF: A Comparative Study

Sadeghzadeh,

Yoo,

Lopez

et al. 2024

JCM

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Background: Anterior lumbar interbody fusion (ALIF) and posterior spinal fusion (PSF) play pivotal roles in restoring lumbar lordosis in spinal surgery. There is an ongoing debate between combined single-position surgery and traditional prone-position PSF for optimizing segmental lumbar lordosis. Methods: This retrospective study analyzed 59 patients who underwent ALIF in the supine position followed by PSF in the prone position at a single institution. Cobb angles were measured preoperatively, post-ALIF, and post-PSF using X-ray imaging. One-way repeated measures ANOVA and post-hoc analyses with Bonferroni adjustment were employed to compare mean Cobb angles at different time points. Cohen’s d effect sizes were calculated to assess the magnitude of changes. Sample size calculations were performed to ensure statistical power. Results: The mean segmental Cobb angle significantly increased from preoperative (32.2 ± 13.8 degrees) to post-ALIF (42.2 ± 14.3 degrees, Cohen’s d: −0.71, p < 0.0001) and post-PSF (43.6 ± 14.6 degrees, Cohen’s d: −0.80, p < 0.0001). There was no significant difference between Cobb angles after ALIF and after PSF (Cohen’s d: −0.10, p = 0.14). The findings remained consistent when Cobb angles were analyzed separately for single-screw and double-screw ALIF constructs. Conclusions: Both supine ALIF and prone PSF significantly increased segmental lumbar lordosis compared to preoperative measurements. The negligible difference between post-ALIF and post-PSF lordosis suggests that supine ALIF followed by prone PSF can be an effective approach, providing flexibility in surgical positioning without compromising lordosis improvement.

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Section: Methodsmentioning

confidence: 99%

Impact of Supine versus Prone Positioning on Segmental Lumbar Lordosis in Patients Undergoing ALIF Followed by PSF: A Comparative Study

Sadeghzadeh,

Yoo,

Lopez

et al. 2024

JCM

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Machine learning applications in adult spinal deformity corrective surgery: a narrative review

Toossi,

Jerry

2024

Art Int Surg

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Adult spinal deformity (ASD) poses significant challenges in spinal surgery, requiring precise planning and execution for successful correction. Additionally, optimization of outcomes and reducing the high complication rates of ASD surgeries are additional challenges facing spinal deformity surgeons. The advent of machine learning (ML) has revolutionized various aspects of healthcare, including spinal surgery. This review provides a comprehensive overview of the current state of ML applications in spinal deformity corrective surgery, highlighting its potential benefits and challenges.

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Evaluation of Mis-Selection of End Vertebrae and Its Effect on Measuring Cobb Angle and Curve Length in Adolescent Idiopathic Scoliosis

Hurtado-Avilés,

León-Muñoz,

Santonja-Medina

et al. 2024

JCM

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Background: The Cobb angle is critical in assessing adolescent idiopathic scoliosis (AIS) patients. This study aimed to evaluate the error in selecting the upper- and lower-end vertebrae on AIS digital X-rays by experienced and novice observers and its correlation with the error in measuring the Cobb angle and determining the length of the scoliotic curves. Methods: Using the TraumaMeter v.873 software, eight raters independently evaluated 68 scoliotic curves. Results: The error percentage in the upper-end vertebra selection was higher than for the lower-end vertebra (44.7%, CI95% 41.05–48.3 compared to 35%, CI95% 29.7–40.4). The mean bias error (MBE) was 0.45 (CI95% 0.38–0.52) for the upper-end vertebra and 0.35 (CI% 0.69–0.91) for the lower-end vertebra. The percentage of errors in the choice of the end vertebrae was lower for the experienced than for the novices. There was a positive correlation (r = 0.673, p = 0.000) between the error in selecting the end vertebrae and determining the length of the scoliotic curves. Conclusions: We can conclude that errors in selecting end vertebrae are common among experienced and novice observers, with a greater error frequency for the upper-end vertebrae. Contrary to the consensus, the accuracy of determining the length of the scoliotic curve is limited by the Cobb method’s reliance on the correct selection of the end vertebrae.

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Spine surgeon versus AI algorithm full-length radiographic measurements: a validation study of complex adult spinal deformity patients

Cited by 3 publications

References 18 publications

Impact of Supine versus Prone Positioning on Segmental Lumbar Lordosis in Patients Undergoing ALIF Followed by PSF: A Comparative Study

Impact of Supine versus Prone Positioning on Segmental Lumbar Lordosis in Patients Undergoing ALIF Followed by PSF: A Comparative Study

Machine learning applications in adult spinal deformity corrective surgery: a narrative review

Evaluation of Mis-Selection of End Vertebrae and Its Effect on Measuring Cobb Angle and Curve Length in Adolescent Idiopathic Scoliosis

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