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Development and Validation of Machine Learning-Based Predictive Model for Clinical Outcome of Decompression Surgery for Lumbar Spinal Canal Stenosis Research Article

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Published article

CONCLUSIONS: We successfully developed a machine learning model to predict the postoperative outcomes of decompression surgery for patients with LSS using patient data from 3 different institutions in 3 different settings. Thorough analyses for the subjects with deviations from the actual measured values may further improve the predictive probability of this model.
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Spine J. 2022 Jun 24:S1529-9430(22)00269-8. doi: 10.1016/j.spinee.2022.06.008. Online ahead of print.

ABSTRACT

BACKGROUND CONTEXT: Although the results of decompression surgery for lumbar spinal canal stenosis (LSS) are favorable, it is still difficult to predict the postoperative HRQoL of patients before surgery.

PURPOSE: The purpose of this study was to develop and validate a machine learning model to predict the postoperative outcome of decompression surgery for patients with LSS.

STUDY DESIGN/SETTING: A multicentered retrospective study.

PATIENT SAMPLE: A total of 848 patients who underwent decompression surgery for LSS at an academic hospital, tertiary center, and private hospital were included (age 71 ± 9 years, 68% male, 91% LSS, level treated 1.8 ± 0.8, operation time 69 ± 37 minutes, blood loss 48 ± 113 mL, and length of hospital stay 12 ± 5 days).

OUTCOME MEASURES: Baseline and 2 years postoperative HRQoLs METHODS: The subjects were randomly assigned in a 7:3 ratio to a model building cohort and a testing cohort to test the models’ accuracy. Twelve predictive algorithms using 68 preoperative factors were used to predict each domain of the JOABPEQ and VAS scores at 2 years postoperatively. The final predictive values were generated using an ensemble of the top 5 algorithms in prediction accuracy.

RESULTS: The correlation coefficients of the top algorithms for each domain established using the preoperative factors were excellent (correlation coefficient: 0.95-0.97 [relative error: 0.06-0.14]). The performance evaluation of each JOABPEQ domain and VAS score by the ensemble of the top 5 algorithms in the testing cohort was favorable (mean absolute error [MAE] 8.9-17.4, median difference [MD] 8.1-15.6/100 points), with the highest accuracy for mental status (MAE 8.9, MD 8.1) and the lowest for buttock and leg numbness (MAE 1.7, MD 1.6/10 points). A strong linear correlation was observed between the predicted and measured values (linear correlation 0.82-0.89), while 4-6% of the subjects had predicted values of greater than ± 3 SD of the MAE.

CONCLUSIONS: We successfully developed a machine learning model to predict the postoperative outcomes of decompression surgery for patients with LSS using patient data from 3 different institutions in 3 different settings. Thorough analyses for the subjects with deviations from the actual measured values may further improve the predictive probability of this model.

PMID:35760319 | DOI:10.1016/j.spinee.2022.06.008

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Development and Validation of Machine Learning-Based Predictive Model for Clinical Outcome of Decompression Surgery for Lumbar Spinal Canal Stenosis

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SW
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2022-06-10
Fabulous service Fabulous service. Mr Akmal truly cares about his patients and how he can improve their quality of life. I would recommend him to anyone with any kind of spinal issue.
Honeywell Paul
Honeywell Paul
2022-06-08
Truly excellent results! I was diagnosed with lumbar stenosis after experiencing increasing pain in both legs. An MRI and consultation carried out at short notice confirmed this. Mr Akmal recommended that a spacer should be inserted in my lower back to correct the problem and release the nerves from the narrowing caused by stenosis. The operation was conducted very professionally and without pain. After the first two weeks the pain started to subside as expected. After 4 weeks I was completely back to normal. The result is exceptionally good and I feel renewed, with no pain whatsoever and a regained posture, ready to resume a normal life. I cannot recommend The London Spine Unit highly enough. They are medical magicians!
c etri
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2022-06-06
Sciatica My mother was in absolute agony for more than 3 months due to sciatica. It just came out of nowhere and took her out of action. From working full time she went straight to being bed bound and unable to carry out simplest of actions.The pain was 9/10 and she was bed bound for those three months. Multiple trips to A&E and GP and they wouldn't class it as an emergency therefore they wouldn't do anything about it other than upgrading the painkillers which did next to nothing for my mother. I couldn't bear to watch my mother sleeping on A&E bench in pain for 7 hours, just to be told by doctors that she wouldn't be kept in. I remember her joining her hands and begging the doctors to stop the pain which broke my heart. I then started doing research on google and London spine unit came up with Dr Mo AKMAL's profile and review. First meeting with Dr AKMAL was via ZOOM as my mother was bed bound. Dr AKMAL spoke to me and my mom and told us that this is nothing to worry about and that the pain would be 100% gone.Dr AKMAL assured us to visit the hospital so he could physically inspect my mother and give us the best solution. One trip to the london spine unit and Dr AKMAL advised us that the best solution would be to carry out Minimally invasive disectomy. Dr AKMAL advised that due to my mother being bed bound for a while, steroid injection might not give the result that my mother wishes. Dr AKMAL was very confident and showed us some videos from other patients who had gone through the same ordeal. The biggest thing i noticed between before and after was the smile on the patients face. Dr AKMAL was constantly assuring my mother throughout the meeting that he would take care of her pain and gave her 100% confidence that the result would be delivered.He promised her that she would be walking pain free the same day after the operation. Before the operation Dr GURUNG was consulted multiple times and he also was very helpful. Right after the surgery, as Dr AKMAL promised, my mother was walking and the biggest thing was that the pain was gone. My mother had forgotten to smile for three months and there i saw her smiling again. Dr AKMAL and Dr GURUNG gave us brilliant aftercare and informed us that just give them a ring if there was any issue. Its been several weeks now and my mother is heading towards complete recovery without any issues. The pain is completely gone and anyone who is reading this going through the same horrible sciatica pain you must come and see Dr AKMAL. Thank you Dr AKMAL and your whole team for helping my mom achieve this pain free life.
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2022-05-18
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2022-05-18
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2022-05-09
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shahnaz Choudhury
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2022-04-22
I had a massive bulging disk on my back… I had a massive bulging disk on my back compressing my nerve for three years. It caused me excruciating pain and almost left me disabled. I was on both crutches and completely homebound due to the severity of pain and mobility limitations. I had my lumber surgery two weeks ago and walked out of hospital within a few hours pain free on my right leg that was almost paralysing prior to surgery. The disk was shaved off releasing the nerve completely. Two days after surgery I had excruciating pain on my head that is unexplained as I had CT scan and MRI which were all fine. Dr Akmal has suggested it could be from the anaesthetic. I am extremely grateful to Dr Akmal and his very welcoming and cari g team. I would highly recommend his clinic as I have had excellent recovery.
MR HARVEY
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2022-04-02
Thank you Mr Aklam After having a poor and very slow experiance in glasgow . I contacted Mr mo Amlam . Who is a true gentleman, great listener and paitent . We transfered my scans and treatments from glasgow to harley street . Mr Aklams p.a arranged a quick zoom to start our contact .I then went down for a meeting and examination and what should have been a spec scan .only to be told of a UK shortage . So 4 weeks later the scan took place in wellington hospital . Before I traveled back to glasgow. 5 days later I got a call to book me in to 19 harley street for a l3 and l4 debridement and stabilisation. The opp took place on 24th March. 2hours I was out walking 4 hours later . My pain in back groin and foot was all gone .thanks to Mr aklam . Top of his craft but more importantly pouts his patients first .he really wants to help you get better. Thank you so much Mr Robert harvey
Ken Carswell
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2022-03-22
Amazing service and an amazing treatment! I can't thank Mr Akmal and team at the London Spine Unit enough for their help. I had a herniated disc in my back which was causing pain and restrictions. Compared to other offers of surgery (e.g. several nights in hospital), the day surgery and minimally invasive procedure were hugely appealing. I am now 3 weeks post surgery, have no pain and am recovering incredibly quickly if I compare myself to friends who have had a similar procedure. it was truly remarkable, straightforward and the team were kind, friendly and always helpful. very highly recommended!
customer
customer
2022-03-17
Great service and painless procedure Great service and painless procedure. Definitely alleviated the pain

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Spine J. 2022 Jun 24:S1529-9430(22)00269-8. doi: 10.1016/j.spinee.2022.06.008. Online ahead of print.ABSTRACTBACKGROUND CONTEXT: Although the results of decompression surgery for lumbar spinal canal stenosis (LSS) are favorable, it is still difficult to predict the postoperative HRQoL of patients before surgery.PURPOSE: The purpose of this study was to develop and validate a machine learning model to predict…

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