Predicting mechanical complications in adult spinal deformity patients with postoperative proportioned and moderately disproportioned alignment

Mechanical complications; Spinal deformity; Postoperative alignment

Detalles Bibliográficos
Autores: Demirci, Nuri, YILGOR, CAGLAR, zulemyan, tais, Balaban, Barış, Yucekul, Altug, Haddad, Sleiman, Pellise, Ferran
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2025
País:España
Institución:Departament de Salut de la Generalitat de Catalunya (DS)
Repositorio:Scientia. Dipòsit d'Informació Digital del Departament de Salut
OAI Identifier:oai:scientiasalut.gencat.cat:11351/13819
Acceso en línea:http://hdl.handle.net/11351/13819
Access Level:acceso abierto
Palabra clave:Escoliosi - Cirurgia - Complicacions
Columna vertebral - Malformacions - Cirurgia - Complicacions
Aprenentatge automàtic
PHENOMENA AND PROCESSES::Mathematical Concepts::Algorithms::Artificial Intelligence::Machine Learning
DISEASES::Pathological Conditions, Signs and Symptoms::Pathologic Processes::Postoperative Complications
DISEASES::Musculoskeletal Diseases::Bone Diseases::Spinal Diseases::Spinal Curvatures
Other subheadings::Other subheadings::Other subheadings::/surgery
DISEASES::Musculoskeletal Diseases::Bone Diseases::Spinal Diseases::Spinal Curvatures::Scoliosis
FENÓMENOS Y PROCESOS::conceptos matemáticos::algoritmos::inteligencia artificial::aprendizaje automático
ENFERMEDADES::afecciones patológicas, signos y síntomas::procesos patológicos::complicaciones posoperatorias
ENFERMEDADES::enfermedades musculoesqueléticas::enfermedades óseas::enfermedades de la columna vertebral::desviaciones de la columna vertebral
Otros calificadores::Otros calificadores::Otros calificadores::/cirugía
ENFERMEDADES::enfermedades musculoesqueléticas::enfermedades óseas::enfermedades de la columna vertebral::desviaciones de la columna vertebral::escoliosis
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oai_identifier_str oai:scientiasalut.gencat.cat:11351/13819
network_acronym_str ES
network_name_str España
repository_id_str
dc.title.none.fl_str_mv Predicting mechanical complications in adult spinal deformity patients with postoperative proportioned and moderately disproportioned alignment
title Predicting mechanical complications in adult spinal deformity patients with postoperative proportioned and moderately disproportioned alignment
spellingShingle Predicting mechanical complications in adult spinal deformity patients with postoperative proportioned and moderately disproportioned alignment
Demirci, Nuri
Escoliosi - Cirurgia - Complicacions
Columna vertebral - Malformacions - Cirurgia - Complicacions
Aprenentatge automàtic
PHENOMENA AND PROCESSES::Mathematical Concepts::Algorithms::Artificial Intelligence::Machine Learning
DISEASES::Pathological Conditions, Signs and Symptoms::Pathologic Processes::Postoperative Complications
DISEASES::Musculoskeletal Diseases::Bone Diseases::Spinal Diseases::Spinal Curvatures
Other subheadings::Other subheadings::Other subheadings::/surgery
DISEASES::Musculoskeletal Diseases::Bone Diseases::Spinal Diseases::Spinal Curvatures::Scoliosis
FENÓMENOS Y PROCESOS::conceptos matemáticos::algoritmos::inteligencia artificial::aprendizaje automático
ENFERMEDADES::afecciones patológicas, signos y síntomas::procesos patológicos::complicaciones posoperatorias
ENFERMEDADES::enfermedades musculoesqueléticas::enfermedades óseas::enfermedades de la columna vertebral::desviaciones de la columna vertebral
Otros calificadores::Otros calificadores::Otros calificadores::/cirugía
ENFERMEDADES::enfermedades musculoesqueléticas::enfermedades óseas::enfermedades de la columna vertebral::desviaciones de la columna vertebral::escoliosis
title_short Predicting mechanical complications in adult spinal deformity patients with postoperative proportioned and moderately disproportioned alignment
title_full Predicting mechanical complications in adult spinal deformity patients with postoperative proportioned and moderately disproportioned alignment
title_fullStr Predicting mechanical complications in adult spinal deformity patients with postoperative proportioned and moderately disproportioned alignment
title_full_unstemmed Predicting mechanical complications in adult spinal deformity patients with postoperative proportioned and moderately disproportioned alignment
title_sort Predicting mechanical complications in adult spinal deformity patients with postoperative proportioned and moderately disproportioned alignment
dc.creator.none.fl_str_mv Demirci, Nuri
YILGOR, CAGLAR
zulemyan, tais
Balaban, Barış
Yucekul, Altug
Haddad, Sleiman
Pellise, Ferran
author Demirci, Nuri
author_facet Demirci, Nuri
YILGOR, CAGLAR
zulemyan, tais
Balaban, Barış
Yucekul, Altug
Haddad, Sleiman
Pellise, Ferran
author_role author
author2 YILGOR, CAGLAR
zulemyan, tais
Balaban, Barış
Yucekul, Altug
Haddad, Sleiman
Pellise, Ferran
author2_role author
author
author
author
author
author
dc.contributor.none.fl_str_mv Institut Català de la Salut
[Balaban B] Department of Biostatistics and Bioinformatics, Institute of Health Sciences, Acibadem Mehmet Ali Aydinlar University, Istanbul, Türkiye. [Demirci N] Acibadem University School of Medicine, Istanbul, Türkiye. [Yilgor C, Yucekul A] Department of Orthopedics and Traumatology, Acibadem University School of Medicine, Istanbul, Türkiye. [Zulemyan T] Comprehensive Spine Center, Acibadem Maslak Hospital, Istanbul, Türkiye. [Haddad S, Pellise F] Unitat de Recerca de la Columna Vertebral, Servei de Cirurgia Ortopèdica i Traumatologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain
Vall d'Hebron Barcelona Hospital Campus
dc.subject.none.fl_str_mv Escoliosi - Cirurgia - Complicacions
Columna vertebral - Malformacions - Cirurgia - Complicacions
Aprenentatge automàtic
PHENOMENA AND PROCESSES::Mathematical Concepts::Algorithms::Artificial Intelligence::Machine Learning
DISEASES::Pathological Conditions, Signs and Symptoms::Pathologic Processes::Postoperative Complications
DISEASES::Musculoskeletal Diseases::Bone Diseases::Spinal Diseases::Spinal Curvatures
Other subheadings::Other subheadings::Other subheadings::/surgery
DISEASES::Musculoskeletal Diseases::Bone Diseases::Spinal Diseases::Spinal Curvatures::Scoliosis
FENÓMENOS Y PROCESOS::conceptos matemáticos::algoritmos::inteligencia artificial::aprendizaje automático
ENFERMEDADES::afecciones patológicas, signos y síntomas::procesos patológicos::complicaciones posoperatorias
ENFERMEDADES::enfermedades musculoesqueléticas::enfermedades óseas::enfermedades de la columna vertebral::desviaciones de la columna vertebral
Otros calificadores::Otros calificadores::Otros calificadores::/cirugía
ENFERMEDADES::enfermedades musculoesqueléticas::enfermedades óseas::enfermedades de la columna vertebral::desviaciones de la columna vertebral::escoliosis
topic Escoliosi - Cirurgia - Complicacions
Columna vertebral - Malformacions - Cirurgia - Complicacions
Aprenentatge automàtic
PHENOMENA AND PROCESSES::Mathematical Concepts::Algorithms::Artificial Intelligence::Machine Learning
DISEASES::Pathological Conditions, Signs and Symptoms::Pathologic Processes::Postoperative Complications
DISEASES::Musculoskeletal Diseases::Bone Diseases::Spinal Diseases::Spinal Curvatures
Other subheadings::Other subheadings::Other subheadings::/surgery
DISEASES::Musculoskeletal Diseases::Bone Diseases::Spinal Diseases::Spinal Curvatures::Scoliosis
FENÓMENOS Y PROCESOS::conceptos matemáticos::algoritmos::inteligencia artificial::aprendizaje automático
ENFERMEDADES::afecciones patológicas, signos y síntomas::procesos patológicos::complicaciones posoperatorias
ENFERMEDADES::enfermedades musculoesqueléticas::enfermedades óseas::enfermedades de la columna vertebral::desviaciones de la columna vertebral
Otros calificadores::Otros calificadores::Otros calificadores::/cirugía
ENFERMEDADES::enfermedades musculoesqueléticas::enfermedades óseas::enfermedades de la columna vertebral::desviaciones de la columna vertebral::escoliosis
description Mechanical complications; Spinal deformity; Postoperative alignment
publishDate 2025
dc.date.none.fl_str_mv 2025
2025
2025
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/11351/13819
url http://hdl.handle.net/11351/13819
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Acta Orthopaedica et Traumatologica Turcica;59(4)
https://doi.org/10.5152/j.aott.2025.24146
dc.rights.none.fl_str_mv Attribution-NonCommercial 4.0 International
http://creativecommons.org/licenses/by-nc/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv Attribution-NonCommercial 4.0 International
http://creativecommons.org/licenses/by-nc/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Turkish Association of Orthopaedics and Traumatology
publisher.none.fl_str_mv Turkish Association of Orthopaedics and Traumatology
dc.source.none.fl_str_mv Scientia
reponame:Scientia. Dipòsit d'Informació Digital del Departament de Salut
instname:Departament de Salut de la Generalitat de Catalunya (DS)
instname_str Departament de Salut de la Generalitat de Catalunya (DS)
reponame_str Scientia. Dipòsit d'Informació Digital del Departament de Salut
collection Scientia. Dipòsit d'Informació Digital del Departament de Salut
repository.name.fl_str_mv
repository.mail.fl_str_mv
_version_ 1869422556159672320
spelling Predicting mechanical complications in adult spinal deformity patients with postoperative proportioned and moderately disproportioned alignmentDemirci, NuriYILGOR, CAGLARzulemyan, taisBalaban, BarışYucekul, AltugHaddad, SleimanPellise, FerranEscoliosi - Cirurgia - ComplicacionsColumna vertebral - Malformacions - Cirurgia - ComplicacionsAprenentatge automàticPHENOMENA AND PROCESSES::Mathematical Concepts::Algorithms::Artificial Intelligence::Machine LearningDISEASES::Pathological Conditions, Signs and Symptoms::Pathologic Processes::Postoperative ComplicationsDISEASES::Musculoskeletal Diseases::Bone Diseases::Spinal Diseases::Spinal CurvaturesOther subheadings::Other subheadings::Other subheadings::/surgeryDISEASES::Musculoskeletal Diseases::Bone Diseases::Spinal Diseases::Spinal Curvatures::ScoliosisFENÓMENOS Y PROCESOS::conceptos matemáticos::algoritmos::inteligencia artificial::aprendizaje automáticoENFERMEDADES::afecciones patológicas, signos y síntomas::procesos patológicos::complicaciones posoperatoriasENFERMEDADES::enfermedades musculoesqueléticas::enfermedades óseas::enfermedades de la columna vertebral::desviaciones de la columna vertebralOtros calificadores::Otros calificadores::Otros calificadores::/cirugíaENFERMEDADES::enfermedades musculoesqueléticas::enfermedades óseas::enfermedades de la columna vertebral::desviaciones de la columna vertebral::escoliosisMechanical complications; Spinal deformity; Postoperative alignmentComplicaciones mecánicas; Deformidad espinal; Alineación postoperatoriaComplicacions mecàniques; Deformitat espinal; Alineació postoperatòriaObjective: Mechanical complications are common after adult spinal deformity (ASD) surgery and can significantly impair outcomes. This study aimed to predict such complications in proportioned and moderately disproportioned patients using a machine learning approach, to inform preoperative planning and enable early preventive care. Methods: Prospectively collected clinical data, including preoperative, intraoperative, and postoperative variables, radiographic param- eters, technical details, and patient-reported outcomes, were obtained from a multi-center ASD surgery database. Parameter tuning of a random forest (RF) classifier was performed using 9-times 3-fold cross-validation over 3 rounds of grid search, with the F-score used as the primary optimization metric. The final RF model was used to derive a clinically interpretable rule set using the inTrees framework. Permutation-based feature importance was assessed for F-score, accuracy, and sensitivity. Results: The model was trained on 295 patients (237 female, 58 male; mean age, 50 ± 19 years) with a minimum 2-year follow-up (mean 53 months, range 24-101). Mechanical complications were observed in 100 patients (34%). A test cohort of 98 patients (33% complication rate) was used for external validation. The RF model achieved 72% accuracy, 91% sensitivity, 64% specificity, and 93% negative predictive value. The derived rule set, comprising 8 rules using 1 to 3 features each, yielded 74% accuracy, 81% sensitivity, 71% specificity, and 83% negative predictive value. The location of the lower instrumented vertebra (LIV) was the most influential predictor. Conclusion: By excluding patients with severe deformities, as defined by the GAP score, this study focused on the more clinically ambiguous group of proportioned and moderately disproportioned patients. To the authors’ knowledge, this is the first study to develop predictive tools specifically for this subgroup to assess the risk of mechanical complications following ASD surgery. These tools may assist in early risk stratification and guide preoperative decision-making to reduce postoperative complications and improve patient outcomes. Level of Evidence: Level III, Prognostic Study.Turkish Association of Orthopaedics and TraumatologyInstitut Català de la Salut[Balaban B] Department of Biostatistics and Bioinformatics, Institute of Health Sciences, Acibadem Mehmet Ali Aydinlar University, Istanbul, Türkiye. [Demirci N] Acibadem University School of Medicine, Istanbul, Türkiye. [Yilgor C, Yucekul A] Department of Orthopedics and Traumatology, Acibadem University School of Medicine, Istanbul, Türkiye. [Zulemyan T] Comprehensive Spine Center, Acibadem Maslak Hospital, Istanbul, Türkiye. [Haddad S, Pellise F] Unitat de Recerca de la Columna Vertebral, Servei de Cirurgia Ortopèdica i Traumatologia, Vall d’Hebron Hospital Universitari, Barcelona, SpainVall d'Hebron Barcelona Hospital Campus202520252025info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttp://hdl.handle.net/11351/13819Scientiareponame:Scientia. Dipòsit d'Informació Digital del Departament de Salutinstname:Departament de Salut de la Generalitat de Catalunya (DS)InglésActa Orthopaedica et Traumatologica Turcica;59(4)https://doi.org/10.5152/j.aott.2025.24146Attribution-NonCommercial 4.0 Internationalhttp://creativecommons.org/licenses/by-nc/4.0/info:eu-repo/semantics/openAccessoai:scientiasalut.gencat.cat:11351/138192026-06-12T09:38:37Z
score 15.812429

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