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Predicting radiographic outcomes of vertebral body tethering in adolescent idiopathic scoliosis patients using machine learning
Journal article   Open access   Peer reviewed

Predicting radiographic outcomes of vertebral body tethering in adolescent idiopathic scoliosis patients using machine learning

Ausilah Alfraihat, Amer F Samdani and Sriram Balasubramanian
PloS one, v 19(1), e0296739
2024
PMID: 38215180
url
https://doi.org/10.1371/journal.pone.0296739View
Published, Version of Record (VoR)CC BY V4.0 Open

Abstract

Adolescent Child Humans Retrospective Studies Scoliosis - diagnostic imaging Scoliosis - surgery Spinal Fusion - methods Thoracic Vertebrae - surgery Treatment Outcome Vertebral Body Radiography
Anterior Vertebral Body Tethering (AVBT) is a growing alternative treatment for adolescent idiopathic scoliosis (AIS), offering an option besides spinal fusion. While AVBT aims to correct spinal deformity through growth correction, its outcomes have been mixed. To improve surgical outcomes, this study aimed to develop a machine learning-based tool to predict short- and midterm spinal curve correction in AIS patients who underwent AVBT surgery, using the most predictive clinical, radiographic, and surgical parameters. After institutional review board approval and based on inclusion criteria, 91 AIS patients who underwent AVBT surgery were selected from the Shriners Hospitals for Children, Philadelphia. For all patients, longitudinal standing (PA or AP, and lateral) and side bending spinal Radiographs were retrospectively obtained at six visits: preop and first standing, one year, two years, five years postop, and at the most recent follow-up. Demographic, radiographic, and surgical features associated with curve correction were collected. The sequential backward feature selection method was used to eliminate correlated features and to provide a rank-ordered list of the most predictive features of the AVBT correction. A Gradient Boosting Regressor (GBR) model was trained and tested using the selected features to predict the final correction of the curve in AIS patients. Eleven most predictive features were identified. The GBR model predicted the final Cobb angle with an average error of 6.3 ± 5.6 degrees. The model also provided a prediction interval, where 84% of the actual values were within the 90% prediction interval. A list of the most predictive features for AVBT curve correction was provided. The GBR model, trained on these features, predicted the final curve magnitude with a clinically acceptable margin of error. This model can be used as a clinical tool to plan AVBT surgical parameters and improve outcomes.

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5 citations in Scopus

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Web of Science research areas
Orthopedics
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