Temporal validation of the SORG 90-Day and 1-Year machine learning algorithms for survival of patients with spinal metastatic disease.

Purpose: The SORG-MLA was developed to predict 90-day and 1-year postoperative survival in patients with spinal metastatic disease who underwent surgery between 2000 and 2016. Due to the constant changes in treatment methods, it is essential to perform temporal validation with a recent patient population. Therefore, the purpose of this study was to validate the Skeletal Oncology Research Group machine learning algorithms (SORG-MLA) using a contemporary patient cohort.

Comparative Analysis of Surgical Outcomes in Separation Surgery vs. Anterior Reconstruction for Metastatic Epidural Spinal Cord Compression.

Study Design: Retrospectively matched case-control study.

Objective: To compare intraoperative and postoperative outcomes between separation surgery and corpectomy with anterior reconstruction for patients with metastatic epidural spinal cord compression (MESCC).

Summary Of Background Data: The primary goal of surgery for MESCC is to preserve and improve neurological function.

Diagnostic accuracy of imaging modalities for detection of spinal metastases: a systematic review and meta-analysis.

Purpose: Detecting spinal metastases is highly relevant in patients with oncological disorders as it can affect the staging and treatment of their disease. We aimed to evaluate the diagnostic performance of computed tomography (CT), magnetic resonance imaging (MRI), FDG positron emission tomography (PET)/CT, bone scintigraphy (BS), and single-photon emission computed tomography (SPECT) for spinal metastases detection.

Methods: Medline, EMBASE, and Web of Science were systematically searched until March 2024 for diagnostic accuracy studies on spinal metastases detection (PROSPERO-registration: CRD42024540139).

Surgical Outcomes After Preoperative Embolization in Hypervascular Spinal Metastases: A Propensity Scored Study of 191 Patients.

Study Design: Retrospective propensity-score matched, case control study at 2 academic tertiary care centers.

Objective: To assess the effect of PE on (1) intraoperative blood loss, defined as conventional estimates of blood loss (EBL) and hemoglobin mass loss, and (2) secondary outcomes in patients with spinal metastases from hypervascular histologies.

Background Context: Preoperative embolization (PE) intends to reduce blood loss during surgery for spinal metastases of hypervascular tumors such as renal cell carcinoma.

Comparison of Classically and Machine Learning Generated Survival Prediction Models for Patients With Spinal Metastasis - A meta-Analysis of Two Recently Developed Algorithms.

Study Design: A systemic review and a meta-analysis. We also provided a retrospective cohort for validation in this study.

Objective: (1) Using a meta-analysis to determine the pooled discriminatory ability of The Skeletal Oncology Research Group (SORG) classical algorithm (CA) and machine learning algorithms (MLA); and (2) test the hypothesis that SORG-CA has less variability in performance than SORG-MLA in non-American validation cohorts as SORG-CA does not incorporates regional-specific variables such as body mass index as input.

Streamlining the Journey of Research Into Clinical Practice: Making Your Patients and Practice Flourish Understanding and Setting Treatment Expectations for Patients With Metastatic Spine Tumors.

Study Design: Literature review with clinical recommendation.

Objective: A concise curation of the latest spine literature exploring the relationship between expectations and satisfaction for patients with metastatic spinal disease (MSD). Deliver recommendations to practicing clinicians regarding interpretation and utilisation of this evidence.

The fatty liver index and risk of incident venous thromboembolism: the Tromsø Study.

Background: For the relationship between obesity and venous thromboembolism (VTE), nonalcoholic fatty liver disease (recently termed metabolic dysfunction-associated steatotic liver disease) is of interest given the hepatic role in hemostasis.

Objectives: We aimed to assess the association between the fatty liver index (FLI), as a proxy for nonalcoholic fatty liver disease, and VTE risk in a population-based cohort.

Methods: Data from the Tromsø 4 (1994-1995) and 6 (2007-2008) surveys were used to calculate the FLI in 9870 participants.

Remineralization Rate of Lytic Lesions of the Spine in Multiple Myeloma Patients Undergoing Radiation Therapy.

Study Design: Retrospective cohort study.

Objective: In general, Multiple Myeloma (MM) patients are treated with systemic therapy including chemotherapy. Radiation therapy can have an important supportive role in the palliative management of MM-related osteolytic lesions.

Hormonal contraceptive use after a first venous thrombotic event and the risk of recurrence in premenopausal women.

Background: Extensive evidence is available on hormonal contraceptive (HC) use and the risk of a first venous thromboembolism (VTE) event. Despite recommendations to discontinue combined HC (CHC) use, some women continue or start its use after a first VTE.

Objectives: We aimed to evaluate the VTE recurrence risk associated with HC use in premenopausal women.

Impact of intraoperative imaging on decision-making during spine surgery: a survey among spine surgeons using simulated intraoperative images.

Purpose: To assess whether the intention to intraoperatively reposition pedicle screws differs when spine surgeons evaluate the same screws with 2D imaging or 3D imaging.

Methods: In this online survey study, 21 spine surgeons evaluated eight pedicle screws from patients who had undergone posterior spinal fixation. In a simulated intraoperative setting, surgeons had to decide if they would reposition a marked pedicle screw based on its position in the provided radiologic imaging.

Surgical treatment of traumatic fractures of the thoracic and lumbar spine: A systematic review.

Introduction: The treatment of traumatic thoracic and lumbar spine fractures remains controversial. To date no consensus exists on the correct choice of surgical approach and technique.

Research Question: to provide a comprehensive up-to-date overview of the available different surgical methods and their quantified outcomes.

The prevalence of vertebral fractures in diffuse idiopathic skeletal hyperostosis and ankylosing spondylitis: A systematic review and meta-analysis.

Background: Subjects with ankylosing spinal disorders, including diffuse idiopathic skeletal hyperostosis (DISH) and ankylosing spondylitis (AS) are more prone to vertebral fractures and frequently present with neurological deficit compared to the patients without an ankylosed spine. Moreover, prevalent vertebral fractures are an important predictor for subsequent fracture risk. However, the pooled fracture prevalence for DISH is unknown and less recent for AS.

Stereotactic Body and Conventional Radiotherapy for Painful Bone Metastases: A Systematic Review and Meta-Analysis.

Importance: Conventional external beam radiotherapy (cEBRT) and stereotactic body radiotherapy (SBRT) are commonly used treatment options for relieving metastatic bone pain. The effectiveness of SBRT compared with cEBRT in pain relief has been a subject of debate, and conflicting results have been reported.

Objective: To compare the effectiveness associated with SBRT vs cEBRT for relieving metastatic bone pain.

Limited health literacy results in lower health-related quality of life in spine patients.

Background Context: Spinal conditions impact health-related quality of life (HRQoL). Patient education and counseling improve HRQoL, yet the effects may be limited for patients with inadequate health literacy (HL). Despite the established relationship between HRQoL and HL in other fields, research in the orthopedic spine population is lacking.

Fracture rate after conventional external beam radiation therapy to the spine in multiple myeloma patients.

Background Context: Conventional external beam radiation therapy (cEBRT) is used in multiple myeloma (MM) to treat severe pain, spinal cord compression, and disease-related bone disease. However, radiation may be associated with an increased risk of vertebral compression fractures (VCFs), which could substantially impair survival and quality of life. Additionally, the use of the Spinal Instability Neoplastic Score (SINS) in MM is debated in MM.

Analysis of complications and revisions after spine surgery in 270 multiple myeloma patients with spinal involvement.

Background Context: Patients with multiple myeloma (MM) are at increased risk of infections and suffer from poor bone quality due to their disseminated malignant bone disease. Therefore, postoperative complications may occur following surgical treatment of MM lesions.

Purpose: In this study, we aimed to determine the incidence of postoperative complications and retreatments after spinal surgery in MM patients.

Accurate Placement and Revisions for Cervical Pedicle Screws Placed With or Without Navigation: A Systematic Review and Meta-Analysis.

Study Design: Systematic review and meta-analysis.

Objectives: To evaluate the accuracy of placement for cervical pedicle screws with and without the use of spinal navigation.

Methods: A structured search was conducted in electronic databases without any language or date restrictions.

Introducing the New Patient Expectations in Spine Oncology Questionnaire.

Background And Objectives: It has been hypothesized that a discrepancy between pretreatment expectations and perceived outcomes is a significant source of patient dissatisfaction. Currently, there is lack in understanding and tools to assess patient expectations regarding the outcomes of treatment for spinal metastases. The objective of this study was therefore to develop a patient expectations questionnaire regarding the outcomes after surgery and/or radiotherapy for spinal metastases.

The Skeletal Oncology Research Group Machine Learning Algorithm (SORG-MLA) for predicting prolonged postoperative opioid prescription after total knee arthroplasty: an international validation study using 3,495 patients from a Taiwanese cohort.

Background: Preoperative prediction of prolonged postoperative opioid use (PPOU) after total knee arthroplasty (TKA) could identify high-risk patients for increased surveillance. The Skeletal Oncology Research Group machine learning algorithm (SORG-MLA) has been tested internally while lacking external support to assess its generalizability. The aims of this study were to externally validate this algorithm in an Asian cohort and to identify other potential independent factors for PPOU.

Comparison of eight modern preoperative scoring systems for survival prediction in patients with extremity metastasis.

Background: Survival is an important factor to consider when clinicians make treatment decisions for patients with skeletal metastasis. Several preoperative scoring systems (PSSs) have been developed to aid in survival prediction. Although we previously validated the Skeletal Oncology Research Group Machine-learning Algorithm (SORG-MLA) in Taiwanese patients of Han Chinese descent, the performance of other existing PSSs remains largely unknown outside their respective development cohorts.