Global Spine Journal最新文献

{"title":"Transiliac-Transsacral Screw Fixation is Superior to Lumbopelvic Stabilization in the Treatment of Minimally Displaced Sacral H-/U-Type Fragility Fractures.","authors":"Jan Gewiess, Ysaline Emilie Roth, Paul Heini, Lorin M Benneker, Christoph Emanuel Albers","doi":"10.1177/21925682241268141","DOIUrl":"https://doi.org/10.1177/21925682241268141","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective Cohort Study.</p><p><strong>Objectives: </strong>To compare the outcomes and complications of transiliac-transsacral screw fixation (TIS) and lumbopelvic fixation (LPS), the 2 most common fixation methods for nondisplaced and minimally displaced H-/U- type sacral fragility fractures.</p><p><strong>Methods: </strong>Medical records of patients treated with TIS or LPS for nondisplaced and minimally displaced H-/U-type sacral fragility fractures at 2 level A trauma centers between 2012 and 2022 were analyzed. Postoperative low back pain and mobility levels were assessed as primary outcomes before discharge and at 6 weeks and 6 months postoperatively. Surgery time, blood loss, and surgical complication rates were assessed as secondary outcomes. Statistical analyses consisted of Fisher's exact tests for frequency distributions and Mann-Whitney-U tests and t-tests for group comparisons.</p><p><strong>Results: </strong>52 patients undergoing TIS (mean age: 78 ± 9 years) and 36 patients undergoing LPS (74 ± 10 years) with no discrepancy in demographic parameters were identified. There were no differences in low back pain levels between the 2 groups before surgery, before discharge, at 6 weeks postoperatively, and at 6 months postoperatively (<i>P</i> > 0.05). There were no differences in mobility levels before surgery, before discharge, at 6 weeks postoperatively, and at 6 months postoperatively (<i>P</i> > 0.05). Duration of surgery was shorter after TIS (36 ± 13 min) compared to LPS (113 ± 31 min) (<i>P</i> < 0.0001). Intraoperative blood loss was lower for TIS (median <20 mL) compared to LPS (median 125 mL) (<i>P</i> < 0.0001). Postoperative radiculopathy was less frequent after TIS (n = 1) compared to LPS (n = 3) (<i>P</i> > 0.05). Median length of stay was shorter after TIS (11 days) compared to LPS (14 days) (<i>P</i> < 0.05). Rates of reoperations directly related to the index surgery were lower after TIS (n = 2) compared to LPS (n = 10) (<i>P</i> < 0.01). Implant failures were observed only after LPS (n = 1).</p><p><strong>Conclusion: </strong>Patients with nondisplaced and minimally displaced H-/U- type sacral fragility fractures may preferably be treated using TIS, as it is equivalent to LPS in terms of low back pain reduction and restoration of mobility, but allows for shorter operative time, less blood loss and lower reoperation rates. Prospective randomized studies should be conducted to substantiate our findings and develop distinct treatment recommendations.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141765875","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":"Representation and Race in Adolescent Idiopathic Scoliosis Research: Disparities in Curve Magnitude and Follow-Up.","authors":"Julia E Todderud, Bharadwaj Jilakara, Michael P Kelly, Michelle C Marks, Nicholas D Fletcher, Joshua M Pahys, Jaysson T Brooks, Peter O Newton, A Noelle Larson","doi":"10.1177/21925682241266787","DOIUrl":"https://doi.org/10.1177/21925682241266787","url":null,"abstract":"<p><strong>Study design: </strong>Prospective Cohort Study.</p><p><strong>Objective: </strong>The present study aims to determine if the racial representation of patients enrolled in a large prospective scoliosis registry is reflective of the general United States population. Further, we studied whether there was an association between race, pre-operative parameters, outcomes and loss to follow-up.</p><p><strong>Methods: </strong>Prospectively collected data for patients who underwent spinal fusion for adolescent idiopathic scoliosis (AIS) was reviewed, including self-reported race/ethnicity. The U.S. pediatric population and U.S. patients enrolled in the prospective registry were compared. The data obtained was analyzed for variations between races, for pre-operative variables and follow-up.</p><p><strong>Results: </strong>Of the 2210 included patients in the registry 66% of patients reported as White, while 52% of the 2018 U.S. pediatric population reported as White. 15% of the registry reported as Hispanic/Latino compared to 22% of the U.S. pediatric population, 13% Black compared to 14% of the U.S. pediatric population, and 4% Asian compared to 5% of the U.S. pediatric population. Asian and White patients had statistically significant higher 2-year follow-up in all but one of six enrollment sites (<i>P</i> < 0.001). Native American, Other, and Hispanic/Latino patients had the highest BMIs. Native American and Black patients had the highest pre-op thoracic Cobb angles. Pre-op ages of Black, Hispanic, and Native American patients were statistically lower (<i>P</i> < 0.01).</p><p><strong>Conclusion: </strong>This study demonstrates the association between race and patient follow-up and pre-operative factors in patients who underwent surgery for AIS. Black, Native American, and Hispanic populations were underrepresented both at pre-op and follow-up when compared to their relative proportion in the U.S. pediatric population.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141733944","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":"Long-Term Outcomes of One-Stage Combined Posteroanterior Procedure and Laminoplasty-Alone for Multilevel Degenerative Cervical Myelopathy With Concomitant Anterior and Posterior Compression: A Propensity Score Matching Analysis of 8-year Follow-Up.","authors":"Ruomu Qu, Yiyuan Yang, Ben Wang, Zexiang Liu, Xiumao Li, Liang Jiang, Xiaoguang Liu, Zhongjun Liu","doi":"10.1177/21925682241265878","DOIUrl":"10.1177/21925682241265878","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Objective: </strong>This study aimed to investigate the long-term outcomes of laminoplasty-alone (LP) and combined procedure (CP), consisting of laminoplasty and single-level anterior cervical discectomy and fusion, in comparable patients who had multilevel degenerative cervical myelopathy (MDCM) with concomitant anterior and posterior compression (CAPC).</p><p><strong>Methods: </strong>Consecutive MDCM patients with CAPC underwent LP or CP between 2012 and 2015 from a same surgical group were enrolled and followed up for a minimum of 8 years. Preoperative demographic, radiological, and clinical variables were collected. Propensity score matching (PSM) analysis was performed to match patients with comparable conditions. The outcomes were evaluated by postoperative Japanese Orthopedic Association (JOA) score improvement, JOA recovery rate (JOARR) and complications.</p><p><strong>Results: </strong>A total of 230 patients were included, of whom 146 underwent LP and 84 underwent CP. After PSM, 84 pairs of comparable patients were matched. The matched groups presented fair comparability in preoperative conditions. The CP group had significantly prolonged surgery time and greater blood loss. At the final follow-up, the postoperative JOA scores of LP and CP groups were 14.51 ± 1.79 and 15.47 ± 1.81 (<i>P</i> < 0.001) and the JOARR were 42.5% ± 53.3% and 68.5% ± 35.4%, respectively (<i>P</i> < 0.001). Three (3.6%) patients in the LP group underwent reoperations because of recurrent symptoms (<i>P</i> = 0.081).</p><p><strong>Conclusion: </strong>Both LP and CP demonstrated considerable long-term neurological recovery in patients with CAPC. The CP showed a significantly higher JOA improvement and JOARR. The combined decompression might be a safe and effective alternative in treating MDCM with CAPC in experienced hands.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141731063","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":"Analyzing the L4-5 Segmental Alignment Change of Two Minimally Invasive Prone-Based Interbody Fusions.","authors":"Michael R McDermott, Michael Rogers, Robert Prior, Joseph Mixa, Jonathon Garrett, Rebecca Michna, Alfredo Guiroy, Jahangir Asghar, Ronjon Paul, Ashish Patel","doi":"10.1177/21925682241266165","DOIUrl":"10.1177/21925682241266165","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective Cohort Study.</p><p><strong>Objective: </strong>Restoration of lumbar lordosis (LL) is a principal objective during spinal fusion procedures, traditionally focusing on achieving an LL within 10° of the pelvic incidence (PI). Recent studies have demonstrated a relatively constant L4-S1 alignment of 35-40° at L4-S1 and at least 15° at L4-5, regardless of PI. Based on these results, this study was created to examine the success rate of achieving a minimum of 15° at L4-5 through two differing prone-based techniques: Prone Lateral (pLLIF) and Trans Foraminal Interbody Fusion (TLIF).</p><p><strong>Methods: </strong>One hundred patients with a primary single-level L4-5 interbody fusion (50 pLLIF and 50 TLIF) were retrospectively analyzed. Pre and post-operative radiographs were measured to examine the segmental change at each level in the lumbar spine and calculate the success rate for achieving a minimum L4-5 segmental lordosis of 15° at the final follow-up.</p><p><strong>Results: </strong>The overall success rate of achieving an L4-5 segmental alignment >15° at the final follow-up was 70%. Prone LLIF was significantly more likely than TLIF to achieve this goal, achieving L4-5 > 15° 84% of the time vs TLIFs 56% (<i>P</i> = 0.002). Prone LLIF demonstrated an average L4-5 increase of 5.6 ± 5.9° which was larger than the mean increase for TLIF 0.4 ± 3.8° (<i>P</i> < 0.001). In both techniques, there was an inverse correlation between pre-operative L4-5 angle and L4-5 angle change.</p><p><strong>Conclusion: </strong>Prone lateral lumbar interbody fusion demonstrates a high success rate for achieving a post-operative L4-5 angle >15° and achieves this at a higher rate than TLIF.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141727104","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":"Corrigendum to \"Streamlining the Journey of Research Into Clinical Practice: Making Your Patients and Practice Flourish\".","authors":"","doi":"10.1177/23259671241264946","DOIUrl":"10.1177/23259671241264946","url":null,"abstract":"","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141727105","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":"Letter re: Letter to the Editor Concerning 'Long-Term Incidence of Adjacent Segmental Pathology after Minimally Invasive vs. Open Transforaminal Lumbar Interbody Fusion'.","authors":"Sitian Niu, Ranran Li, Jingzhi Wang","doi":"10.1177/21925682241266229","DOIUrl":"https://doi.org/10.1177/21925682241266229","url":null,"abstract":"","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141616253","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 COVID-19 on Spinal Diagnosis and Procedural Volume in the United States.","authors":"Omar H Tarawneh, Steven Garay-Morales, Ivan Z Liu, Haig Pakhchanian, Syed Faraz Kazim, Katie Roster, Lea McDaniel, Sean A Tabaie, John Vellek, Rahul Raiker, Meic H Schmidt, Christian A Bowers, Tony Tannoury, Chadi Tannoury","doi":"10.1177/21925682231153083","DOIUrl":"10.1177/21925682231153083","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective analysis of a national database.</p><p><strong>Objectives: </strong>COVID-19 resulted in the widespread shifting of hospital resources to handle surging COVID-19 cases resulting in the postponement of surgeries, including numerous spine procedures. This study aimed to quantify the impact that COVID-19 had on the number of treated spinal conditions and diagnoses during the pandemic.</p><p><strong>Methods: </strong>Using CPT and ICD-10 codes, TriNetX, a national database, was utilized to quantify spine procedures and diagnoses in patients >18 years of age. The period of March 2020-May 2021 was compared to a reference pre-pandemic period of March 2018-May 2019. Each time period was then stratified into four seasons of the year, and the mean average number of procedures per healthcare organization was compared.</p><p><strong>Results: </strong>In total, 524,394 patient encounters from 53 healthcare organizations were included in the analysis. There were significant decreases in spine procedures and diagnoses during March-May 2020 compared to pre-pandemic levels. Measurable differences were noted for spine procedures during the winter of 2020-2021, including a decrease in lumbar laminectomy and anterior cervical arthrodesis. Comparing the pandemic period to the pre-pandemic period showed significant reductions in most spine procedures and treated diagnoses; however, there was an increase in open repair of thoracic fractures during this period.</p><p><strong>Conclusions: </strong>COVID-19 resulted in a widespread decrease in spinal diagnosis and treated conditions. An inverse relationship was observed between new COVID-19 cases and spine procedural volume. Recent increases in procedural volume from pre-pandemic levels are promising signs that the spine surgery community has narrowed the gap in unmet care produced by the pandemic.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5c/64/10.1177_21925682231153083.PMC9892815.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10636432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intradural Extramedullary Pyogenic Abscess: Incidence, Management, and Clinical Outcomes in 45 Patients With a Mean Follow Up of 2 Years.","authors":"Pavlina Lenga, Stepan Fedorko, Gelo Gülec, Cand Med, Karl Kiening, Andreas W Unterberg, Basem Ishak","doi":"10.1177/21925682231151640","DOIUrl":"10.1177/21925682231151640","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective review.</p><p><strong>Objectives: </strong>Spinal intradural extramedullary abscess (SIEA) is a rare disease with an unknown incidence. In this study, we systematically described the clinical course of SIEA in a large cohort with acute onset of neurological illness, assessed the morbidity and mortality rates, and determined the potential risk factors for mortality.</p><p><strong>Methods: </strong>Electronic medical records of patients diagnosed with SIEA at a single institution for the period between September 2005 and December 2020 were retrieved.</p><p><strong>Results: </strong>Over a period of 15 years, 881 patients with spinal infections were treated either conservatively or surgically at our center, of whom 45 patients (45/881, 5.1%) had SIEA. The overall mean age was 69.6 ± 5.6 years of patients diagnosed with SIEA and all of them underwent posterior decompression via laminectomy. The mean Charlson Comorbidity Index (CCI) was 6.9 ± 2.5, indicating a poor baseline reserve. Progressive neurological decline was observed in all patients (mean motor score, 88.6 ± 9.7). The in-hospital rate and 90-day mortality were 4.4% and 10%, respectively. Mortality was not surgery related. Most importantly, the patients' motor deficits and blood infection parameters significantly improved after surgery. Risk factors for mortality were increased age, comorbidities as measured by CCI, and preoperative motor weakness (MS).</p><p><strong>Conclusions: </strong>Immediate surgical decompression via laminectomy, with antiseptic irrigation and drainage of the subdural space, followed by antibiotic therapy, appears to be the key to ensuring beneficial clinical outcomes to treatment of rare diseases such as SIEA.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11268304/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9072251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel AI-Based Algorithm for the Automated Computation of Coronal Parameters in Adolescent Idiopathic Scoliosis Patients: A Validation Study on 100 Preoperative Full Spine X-Rays.","authors":"Clara Berlin, Sonja Adomeit, Priyanka Grover, Marcel Dreischarf, Henry Halm, Oliver Dürr, Peter Obid","doi":"10.1177/21925682231154543","DOIUrl":"10.1177/21925682231154543","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective, mono-centric cohort research study.</p><p><strong>Objectives: </strong>The purpose of this study is to validate a novel artificial intelligence (AI)-based algorithm against human-generated ground truth for radiographic parameters of adolescent idiopathic scoliosis (AIS).</p><p><strong>Methods: </strong>An AI-algorithm was developed that is capable of detecting anatomical structures of interest (clavicles, cervical, thoracic, lumbar spine and sacrum) and calculate essential radiographic parameters in AP spine X-rays fully automatically. The evaluated parameters included T1-tilt, clavicle angle (CA), coronal balance (CB), lumbar modifier, and Cobb angles in the proximal thoracic (C-PT), thoracic, and thoracolumbar regions. Measurements from 2 experienced physicians on 100 preoperative AP full spine X-rays of AIS patients were used as ground truth and to evaluate inter-rater and intra-rater reliability. The agreement between human raters and AI was compared by means of single measure Intra-class Correlation Coefficients (ICC; absolute agreement; >.75 rated as excellent), mean error and additional statistical metrics.</p><p><strong>Results: </strong>The comparison between human raters resulted in excellent ICC values for intra- (range: .97-1) and inter-rater (.85-.99) reliability. The algorithm was able to determine all parameters in 100% of images with excellent ICC values (.78-.98). Consistently with the human raters, ICC values were typically smallest for C-PT (eg, rater 1A vs AI: .78, mean error: 4.7°) and largest for CB (.96, -.5 mm) as well as CA (.98, .2°).</p><p><strong>Conclusions: </strong>The AI-algorithm shows excellent reliability and agreement with human raters for coronal parameters in preoperative full spine images. The reliability and speed offered by the AI-algorithm could contribute to the efficient analysis of large datasets (eg, registry studies) and measurements in clinical practice.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11268300/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10628627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determining Prior Authorization Approval for Lumbar Stenosis Surgery With Machine Learning.","authors":"Amaury De Barros, Frederik Abel, Serhii Kolisnyk, Gaspere C Geraci, Fred Hill, Mary Engrav, Sundara Samavedi, Olga Suldina, Jack Kim, Andrej Rusakov, Darren R Lebl, Raphael Mourad","doi":"10.1177/21925682231155844","DOIUrl":"10.1177/21925682231155844","url":null,"abstract":"<p><strong>Study design: </strong>Medical vignettes.</p><p><strong>Objectives: </strong>Lumbar spinal stenosis (LSS) is a degenerative condition with a high prevalence in the elderly population, that is associated with a significant economic burden and often requires spinal surgery. Prior authorization of surgical candidates is required before patients can be covered by a health plan and must be approved by medical directors (MDs), which is often subjective and clinician specific. In this study, we hypothesized that the prediction accuracy of machine learning (ML) methods regarding surgical candidates is comparable to that of a panel of MDs.</p><p><strong>Methods: </strong>Based on patient demographic factors, previous therapeutic history, symptoms and physical examinations and imaging findings, we propose an ML which computes the probability of spinal surgical recommendations for LSS. The model implements a random forest model trained from medical vignette data reviewed by MDs. Sets of 400 and 100 medical vignettes reviewed by MDs were used for training and testing.</p><p><strong>Results: </strong>The predictive accuracy of the machine learning model was with a root mean square error (RMSE) between model predictions and ground truth of .1123, while the average RMSE between individual MD's recommendations and ground truth was .2661. For binary classification, the AUROC and Cohen's kappa were .959 and .801, while the corresponding average metrics based on individual MD's recommendations were .844 and .564, respectively.</p><p><strong>Conclusions: </strong>Our results suggest that ML can be used to automate prior authorization approval of surgery for LSS with performance comparable to a panel of MDs.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11268295/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10725229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}