European Spine Journal最新文献

{"title":"Presentation and surgical management approaches of giant presacral and sacral schwannomas: a case report and systematic review and meta-analysis.","authors":"Khalid Sarhan, Ibrahim Serag, Amin Sabry, Hossam Elghareeb, Mostafa Shahein","doi":"10.1007/s00586-024-08641-8","DOIUrl":"10.1007/s00586-024-08641-8","url":null,"abstract":"<p><strong>Background: </strong>Giant sacral and presacral schwannomas are very rare conditions and their prevalence is estimated to account for only 0.3 to 3.3% of overall schwannomas. Current published literature about these tumors is limited to case reports and small case series. In this paper we systematically reviewed and analyzed the available literature on giant sacral schwannomas focusing on identifying the presenting symptoms, Klimo type, surgical approach, recurrence rate and postoperative complications.</p><p><strong>Methods: </strong>Following the PRISMA guidelines, we conducted a literature search on electronic databases to obtain the relevant studies until March 2024. We included reports of surgically managed giant sacral schwannomas; either involving tumor of at least 2 adjacent vertebra or had a maximum diameter of 5 cm or more. Presenting symptoms, tumor size, morphology, surgical approach and postoperative complications were reported.</p><p><strong>Results: </strong>A total of 102 studies with 201 unique patients were included in our analysis (mean age 45.4 ± 9.8, 49.7% females). The most common presenting symptoms were lower extremity radicular pain (19.5%), lower back pain (14.1%), lower extremity numbness or paresthesia (9%), and constipation (7.6%). Most surgeries used an open posterior approach (40.1%) or open anterior approach (33.5%). Postoperative complications occurred in (29.3%) of patients and 10% had local recurrence or progression of their tumor. On linear regression the volume of the tumor could significantly predict the estimated amount of blood loss (P = 0.03). We found that an anterior approach was far more likely to be used in patients with Klimo type III, (P < 0.001). Similarly, posterior approach was mostly used for Klimo type I and type II (P < 0.001).</p><p><strong>Conclusion: </strong>The management approach of giant sacral and presacral schwannomas are mainly tailored according to the tumor size and location. Due to the benign nature and the overall recurrence rate of the tumor, frequent imaging follow-up is required after safe resection with adequate clean margins.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":"874-886"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143002878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inter-observer variability in the classification of lumbar foraminal stenosis in magnetic resonance imaging using different evaluation scales.","authors":"José Sá Silva, Ana Pereira, Vasco Abreu, João Pedro Filipe","doi":"10.1007/s00586-024-08612-z","DOIUrl":"10.1007/s00586-024-08612-z","url":null,"abstract":"<p><strong>Background: </strong>The evaluation of lumbar spine degeneration on magnetic resonance imaging (MRI) is prone to inter-reader variability, including when assessing foraminal changes. This variability, often due to subjective criteria and inconsistent terminology, may affect clinical correlations. Standardized criteria could help improve agreement among readers.</p><p><strong>Materials and methods: </strong>MRI of the lumbar spine of 50 randomly selected patients were evaluated by 12 independent readers. Foraminal stenosis was assessed using four different rating scales for each patient. The first scale classified stenosis as presence/absence of neurologic compromise of the spinal nerve root at the foramen, the second scale classified stenosis as absent/mild/moderate/severe, the third scale as normal/contact of disk or osteophyte with the nerve root/deviation of the nerve root/compression of the nerve root, and the fourth scale utilized the Lee et al. criteria. Agreement analysis was performed using Fleiss' kappa coefficients.</p><p><strong>Results: </strong>Agreement was moderate using the first scale (k = 0.439), and significantly lower using the second, third and fourth scales (k = 0.310, k = 0.311, k = 0.295, respectively). When comparing the agreements obtained between board certified neuroradiologists and between neuroradiology residents, there was statistically significant differences when using the third and fourth scales, where the agreement for board certified neuroradiologists was higher, but still only fair. Individual kappas showed that in the second, third, and fourth scales the levels of agreement were higher in the extremes of the scale, namely, when there was no stenosis or when the stenosis was maximal with nerve compression.</p><p><strong>Conclusions: </strong>Levels of agreement can differ depending on the scale used. Simpler dichotomous scales may return higher levels of agreement compared to more complex ones. For the non-dichotomous scales, using different scales may not result in overall different levels of agreement. Given the overall low inter-rater agreements observed, there is probably significant potential to enhance agreement through more rigorous training and consensus-building.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":"869-873"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142863807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sacrum1-pubic angle: a novel and alternative morphologic radiological parameter for assessing spinopelvic sagittal alignment in human adults.","authors":"Feiyu Zu, Hao Qi, Chenchen Wang, Zenghui Zhao, Zhaoxuan Wang, Chenxi Wang, Wei Chen, Zhiyong Hou, Rui Xue, Di Zhang","doi":"10.1007/s00586-025-08681-8","DOIUrl":"10.1007/s00586-025-08681-8","url":null,"abstract":"<p><strong>Objective: </strong>Spinopelvic sagittal balance ensures efficient posture and minimizes energy expenditure by aligning the spine, pelvis, and lower extremities. Deviations can cause clinical issues like back pain and functional limitations. Key radiographic parameters, including pelvic tilt (PT), pelvic incidence (PI), sacral slope (SS), and lumbar lordosis (LL), are essential for evaluating spinal pathologies and planning surgeries. Accurate PI measurement is challenging in certain conditions, necessitating alternative parameters. This study aimed to introduce a new, easily measurable parameter and examine its reliability and correlation with established sagittal parameters.</p><p><strong>Methods: </strong>This study analyzed 107 asymptomatic adult volunteers (57 males and 50 females), with an average age of 36.75 years. Whole-spine radiographs in the standing position were taken using EOS technology. The established spinopelvic sagittal parameters and a novel parameter, sacrum1-pubic angle (S1PA), were measured. The correlation coefficient of each parameter, the regression equation of PI using S1PA, and the regression equation of PTα using PTβ were obtained. The intraclass correlation coefficients (ICCs) was calculated to evaluate the measurement reliability.</p><p><strong>Results: </strong>Morphologic (S1PA, PI) and positional parameters (PTα, PTβ, PTγ, SS, LL) showed no significant gender differences (p > 0.05). S1PA had strong correlations with PI (r = -0.883, p < 0.001) and other parameters. PTα demonstrated a strong correlation with PTβ (r = -0.929, p < 0.001). PI could be predicted according to the regression equation: PI = 71.672 - 4.537 × S1PA (R² = 0.779, p < 0.001). The PTα could be predicted using the following equation: PTα = 67.245 - 0.865 × PTβ (R² = 0.864, p < 0.001). Reliability analysis showed high intra- and inter-rater agreement in all the spinopelvic parameters.</p><p><strong>Conclusion: </strong>The S1PA is a dependable parameter for evaluating the morphology and orientation of the pelvis. PI could be precisely predicted using the S1PA. These insights are valuable for clinicians, enhancing their ability to assess spinopelvic sagittal alignment accurately.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":"910-917"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effective disc age: a statistical model for age-dependent and level-specific lumbar disc degeneration using magnetic resonance imaging (MRI).","authors":"Harrah R Newman, John M Peloquin, Kyle D Meadows, Barry A Bodt, Edward J Vresilovic, Dawn M Elliott","doi":"10.1007/s00586-025-08729-9","DOIUrl":"10.1007/s00586-025-08729-9","url":null,"abstract":"<p><strong>Purpose: </strong>Intervertebral disc degeneration progresses with normal aging; yet common disc grading schemes do not account for age. Degeneration progression also varies between spine levels and is similarly not accounted for by current grading schemes. These limitations inhibit differentiation between discs with normal and expected aging (non-pathological) and discs with accelerated degeneration (which may be pathological). We sought to develop a statistical model to quantify normal age and spine level dependent disc degeneration.</p><p><strong>Methods: </strong>Eighty-four asymptomatic adult subjects ranging evenly from 18 to 83 years old underwent magnetic resonance imaging (MRI) of the lumbar spine. Subject traits, MRI-derived disc geometry, and MRI biomarkers of T2 relaxation time were evaluated and used to develop a statistical model to predict effective disc age, the age at which normal aging would produce a disc's observed phenotype.</p><p><strong>Results: </strong>After evaluating several models, a 4-predictor model utilizing 1) subject height, 2) nucleus pulposus T2 relaxation time, 3) disc mid-sagittal area and 4) disc 3D volume, optimally estimated effective disc age. The effective age closely tracked true age for spine levels L1-L5 (R² ≈ 0.7, RMSE ≈ 10 years) and moderately tracked true age for L5-S1 (R² = 0.4, RMSE = 14 years). The uncertainty in the effective disc age prediction was ± 3 years as assessed by fivefold cross validation.</p><p><strong>Conclusion: </strong>We offer a data-driven, quantitative tool to quantify normal, expected intervertebral disc aging. This effective age model allows future research to target discs with accelerated degeneration.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143536957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of joint hypermobility on lumbar positional changes in back pain patients: a cross-sectional weight-bearing MRI study.","authors":"Ingrid Thorseth, Cecilie Lerche Nordberg, Mikael Boesen, Henning Bliddal, Gilles Ludger Fournier, Philip Hansen, Sabrina Mai Nielsen, Bjarke Brandt Hansen","doi":"10.1007/s00586-024-08577-z","DOIUrl":"10.1007/s00586-024-08577-z","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate positional lumbar changes by weight-bearing MRI in low back pain (LBP) patients with hypermobile joints (Beighton score ≥ 4).</p><p><strong>Methods: </strong>Patients referred to weight-bearing MRI went through a clinical examination, including Beighton's test, answered back pain-related questionnaires, and were hereafter imaged in supine and standing in a 0.25-T MRI unit. All MRI exams were evaluated for degenerative findings i.e., herniations, disc degeneration, spinal stenosis, disc degeneration, and spondylolisthesis. Subsequently, the lumbar lordosis angle, the sacral angle, and all spondylolisthesis' slippages were measured for both positions.</p><p><strong>Results: </strong>Of 257 LBP patients, Beighton score ≥ 4 were seen in 48 patients, and these included more females (81.3% vs. 51.7%), younger patients (mean difference [MD]: -8.1 years), and had less degenerated lumbar discs (sum-score MD: -0.9). No difference between groups in degenerative MRI findings was found, although, a non-significant tendency (p = 0.072) to a higher number of anterolisthesis in the hypermobile patients. The hypermobile patients had a greater lordosis angle both during supine and standing and a greater sacral angle in supine, however, changes in the angles between supine and standing were without difference between groups. A sensitivity analysis adjusted for gender and age confirmed these findings.</p><p><strong>Conclusion: </strong>Hypermobility in LBP patients was associated with being female, younger, having increased lumbar lordosis both during standing and in supine, however, was not associated with increased back pain, anterolisthesis grade or more severe lumbar changes between positions.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":"1071-1078"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142738820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Machine learning in predicting cauda equina imaging outcomes- a solution to the problem.","authors":"Rosa Sun, Abdelmageed Abdelrahman Ramadan, Thaaqib Nazar, Ghayur Abbas, Amin Andalib, Azam Majeed, Jasmeet Dhir, Marcin Czyz","doi":"10.1007/s00586-024-08591-1","DOIUrl":"10.1007/s00586-024-08591-1","url":null,"abstract":"<p><strong>Purpose: </strong>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).</p><p><strong>Methods: </strong>Data of 499 patients who underwent MRI scan for CES-S was collected for demographics, red flag symptoms and radiological outcome. The dataset was used to train the machine learning algorithm in predicting MRI-derived diagnosis of CES. In the testing phase output predictions and Confidence of Prediction (CoP) were recorded for each case and further analysed.</p><p><strong>Results: </strong>Of 499 patients, 12 (2.4%) had positive radiological outcomes for CES. Patients were divided into two subgroups based on their CoP: high (< 0.9) and low (< 0.9). High CoP was observed in 482 (96.6%) cases. In this group all predictions were correct: 476 negative and 6 positives. Low CoP was observed in 17 (3.4%) cases, of which 6 predictions were incorrect - false negatives. Performing MRI scans only in cases with high CoP positive predictions and all low CoP cases would reduce scans to 5% of the original number.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":"1156-1163"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142767729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The use of cervical interfacet devices and related clinical outcomes.","authors":"Michael S Hisey, Emily C Courtois, Donna D Ohnmeiss","doi":"10.1007/s00586-024-08626-7","DOIUrl":"10.1007/s00586-024-08626-7","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to investigate the outcomes of minimally invasive PCF using an interfacet joint fusion cage.</p><p><strong>Methods: </strong>The inclusion criteria consisted of patients who underwent a PCF using an interfacet device (Cavux, Providence Medical Technology Inc.) at a single institution and were at least 6 months postoperative. Charts were reviewed for pre-, intra- and postoperative data including arm and neck pain scores, Neck Disability Index (NDI), complications, and reoperations.</p><p><strong>Results: </strong>A consecutive series of 51 patients were included. Mean age was 54.9 years and 72.6% of patients (n = 37) were female. Most patients (n = 39, 76.5%) had a prior anterior cervical fusion resulting in pseudarthrosis. In total, 157 interfacet devices were implanted in 79 levels. There was statistically significant improvement from pre- to postoperative arm pain (3.8 vs. 2.4), neck pain (6.2 vs. 4.0), and NDI (42.2 vs. 34.9). With the exception of neck pain, these changes would not generally be considered clinically relevant. Ten (19.6%) reoperations occurred, with 4 (7.8%) involving interfacet device removal. The removals were due to: nonunion, device malpositioning, osteophytic overgrowth, trauma, and implantation of additional posterior instrumentation.</p><p><strong>Conclusion: </strong>Performing a minimally invasive facet fusion may be an effective option for treating patients with a history of nonunion. Although the reoperation rate was high in this challenging cohort, only 4 out of 10 reoperations required device removal. More research is warranted to refine indications for this procedure and review larger samples of patients.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":"1211-1217"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143003018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utility of minimally invasive percutaneous arthrodesis of the sacroiliac joint for the treatment of low back pain: systematic review of the literature.","authors":"Juan Carlos Acevedo-Gonzalez, Isabella Lacouture-Silgado","doi":"10.1007/s00586-024-08629-4","DOIUrl":"10.1007/s00586-024-08629-4","url":null,"abstract":"<p><strong>Background: </strong>The surprising increase observed in recent years in the use of minimally invasive sacroiliac joint arthrodesis techniques as a treatment for low back pain justifies an objective review of this results.</p><p><strong>Purpose: </strong>carry out a systematic review of the literature to evaluate the clinical results of patients with low back pain treated with percutaneous arthrodesis of the SIJ.</p><p><strong>Study design: </strong>Systematic review.</p><p><strong>Methods: </strong>Systematic search of the medical literature. The words used in the Search were: \"Hollow screw system\", \"percutaneous sacroiliac joint stabilization\", \"sacroiliac joint\", \"minimally invasive\", \"sacroiliac pain\", \"sacroiliac dysfunction\". With logical connectors such as \"and\", \"not\" and \"or\".</p><p><strong>Databases: </strong>Pubmed, Scopus, Embase, Ovid, EBSCO host and google scholar. The search extended from the beginning of the databases until September 2024. The \"Rayyan\" program was used to collect the information and facilitate the analysis process.</p><p><strong>Inclusion criteria: </strong>Systematic review from the literature, clinical trials, observational studies and case series. They followed PRISMA principles.</p><p><strong>Results: </strong>661 articles were found, of which 108 articles were duplicates. The criteria (Inclusion/Exclusion) were applied to the 553 articles identified based on the independent reading of the summaries by each of the authors on the Rayyan platform and 434 articles were excluded. The 119 selected articles were completely reviewed to finally obtain 102 articles included in the review. Epidemiological data were extracted into an Excel table, methodological and related to clinical results and safety of procedures made. The Prisma checklist for systematic reviews was applied in each article. The epidemiological quality of the articles was evaluated based on the checklists STROBE and CONSORT. The results regarding clinical improvement were overwhelming. However, most of the studies were sponsored by industry and with a limited population and follow-up not always prolonged.</p><p><strong>Conclusions: </strong>Although the clinical results regarding the effectiveness of SIJ fusion are forceful for their effectiveness, we recommend considering some aspects for their analysis and especially long-term studies.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":"974-1003"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to functional restoration in non-specific chronic low back pain with Modic type 1 changes.","authors":"Louis Jacob, Agathe Clouzeau, Agnès Ostertag, David Petrover, Jean-François Vergnol, Odile Morchoisne, Léa Pavan, Marion Landais, Thomas Davergne, Augustin Latourte, Pascal Richette, Johann Beaudreuil","doi":"10.1007/s00586-025-08665-8","DOIUrl":"10.1007/s00586-025-08665-8","url":null,"abstract":"<p><strong>Purpose: </strong>Little information exists on the potential differential response to functional restoration between non-specific chronic low back pain (NSCLBP) individuals with and those without Modic type 1 changes. Therefore, this case-control study investigated the response profile of NSCLBP patients with and without Modic type 1 changes undergoing functional restoration.</p><p><strong>Methods: </strong>The present study included patients participating in a functional restoration program (day-hospital program lasting five weeks) at a French tertiary care center from 2009 to 2019. Each case with Modic type 1 changes was matched to one to two controls without Modic type 1 changes by sex, working incapacity, and lumbar spine surgery history. The primary effectiveness outcome was the Quebec Back Pain Disability Scale (QBPDS) score (0-100, with higher scores indicating higher disability). There were multiple secondary outcomes, such as subjective improvement and return to work.</p><p><strong>Results: </strong>The study included 83 patients (cases: median [IQR] age 47.8 [11.6] years, 77.4% women; controls: median [IQR] age 46.0 [16.2] years, 75.0% women). At three months, there were no statistically significant differences between cases and controls in the QBPDS score (34.0 versus 31.5), subjective improvement (67.7% versus 69.2%), return to work in those who were not working at the inclusion (72.7% versus 52.6%), and the consumption of different analgesics.</p><p><strong>Conclusion: </strong>The response profile of NSCLBP adults undergoing functional restoration did not statistically differ between the groups with and without Modic type 1 changes. These findings suggest that patients may benefit from such a program irrespective of their Modic type 1 status.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":"1095-1106"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143032799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An integrative nomogram based on MRI radiomics and clinical characteristics for prognosis prediction in cervical spinal cord Injury.","authors":"Zifeng Zhang, Ning Li, Yi Ding, Huilin Cheng","doi":"10.1007/s00586-024-08609-8","DOIUrl":"10.1007/s00586-024-08609-8","url":null,"abstract":"<p><strong>Objective: </strong>To construct a nomogram model based on magnetic resonance imaging (MRI) radiomics combined with clinical characteristics and evaluate its role and value in predicting the prognosis of patients with cervical spinal cord injury (cSCI).</p><p><strong>Methods: </strong>In this study, we assessed the prognosis of 168 cSCI patients using the American Spinal Injury Association (ASIA) scale and the Functional Independence Measure (FIM) scale. The study involved extracting radiomics features using both manually defined metrics and features derived through deep learning via transfer learning methods from MRI sequences, specifically T1-weighted and T2-weighted images (T1WI & T2WI). The feature selection was performed employing the least absolute shrinkage and selection operator (Lasso) regression across both radiomics and deep transfer learning datasets. Following this selection process, a deep learning radiomics signature was established. This signature, in conjunction with clinical data, was incorporated into a predictive model. The efficacy of the models was appraised using the area under the receiver operating characteristic curve (AUC), calibration curve and decision curve analysis (DCA) to assess their diagnostic performance.</p><p><strong>Results: </strong>Comparing the effectiveness of the models by linking the AUC of each model, we chose the best-performance radiomics model with clinical model to create the final nomogram. Our analysis revealed that, in the testing cohort, the combined model achieved an AUC of 0.979 for the ASIA and 0.947 for the FIM. The training cohort showed more promising performance, with an AUC of 0.957 for ASIA and 1.000 for FIM. Furthermore, the calibration curve showed that the predicted probability of the nomogram was consistent with the actual incidence rate and the DCA curve validated its effectiveness as a prognostic tool in a clinical setting.</p><p><strong>Conclusion: </strong>We constructed a combined model that can be used to help predict the prognosis of cSCI patients with radiomics and clinical characteristics, and further provided guidance for clinical decision-making by generating a nomogram.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":"1164-1176"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142822069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}