scholarly journals A Functional Outcome Prediction Model of Acute Traumatic Spinal Cord Injury Based on Extreme Gradient Boost

2021 ◽  
Author(s):  
Sizheng Zhan ◽  
Boxuan Huang ◽  
Wenyong Xie ◽  
Feng Xue ◽  
Dianying Zhang ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Prediction Model ◽  
Functional Outcome ◽  
Nonlinear Regression ◽  
Spinal Injury ◽  
Surgical Decompression ◽  
Cord Injury ◽  
The Difference ◽  
Outcome Index

Abstract Purpose: We aimed to construct a nonlinear regression model through Extreme Gradient Boost (XGBoost) to predict functional outcome 1 year after surgical decompression for patients with acute spinal cord injury (SCI).Methods: We prospectively enrolled 249 patients with acute SCI from 5 primary orthopedic centers from June 1, 2016, to June 1, 2020. We identified a total of 6 predictors with three aspects: 1) clinical characteristics, including age, American Spinal Injury Association (ASIA) Impairment Scale (AIS) at admission, level of injury and baseline ASIA motor score (AMS); 2) MR imaging, mainly including Brain and Spinal Injury Center (BASIC) score; 3) surgical timing, specifically comparing whether surgical decompression was received within 24 hours or not. We assessed the SCIM score at 1 year after the operation as the functional outcome index. XGBoost was used to build a nonlinear regression prediction model through the method of boosting integrated learning.Results: We successfully constructed a nonlinear regression prediction model through XGBoost and verified the credibility. The average absolute value of the difference between the predicted value and the actual value is 3.72 (t=1.29, P=0.203), ranging from 0 to 8.44. AMS and age ranked first and second in predicting the functional outcome.Conclusion: We verified the feasibility of using XGBoost to construct a nonlinear regression prediction model for the functional outcome of patients with acute SCI, and we found that age and AMS play the most important role in predicting the functional outcome.Trial registration: ClinicalTrials.gov identifier: NCT03103516.

scholarly journals A Functional Outcome Prediction Model of Acute Traumatic Spinal Cord Injury Based on Extreme Gradient Boost

2021 ◽  
Author(s):  
Sizheng Zhan ◽  
Boxuan Huang ◽  
Wenyong Xie ◽  
Feng Xue ◽  
Dianying Zhang ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Prediction Model ◽  
Functional Outcome ◽  
Nonlinear Regression ◽  
Spinal Injury ◽  
Surgical Decompression ◽  
Cord Injury ◽  
The Difference ◽  
Outcome Index

Abstract Purpose: We aimed to construct a nonlinear regression model through Extreme Gradient Boost (XGBoost) to predict functional outcome 1 year after surgical decompression for patients with acute spinal cord injury (SCI).Methods: We prospectively enrolled 249 patients with acute SCI from 5 primary orthopedic centers from June 1, 2016, to June 1, 2020. We identified a total of 6 predictors with three aspects: 1) clinical characteristics, including age, American Spinal Injury Association (ASIA) Impairment Scale (AIS) at admission, level of injury and baseline ASIA motor score (AMS); 2) MR imaging, mainly including Brain and Spinal Injury Center (BASIC) score; 3) surgical timing, specifically comparing whether surgical decompression was received within 24 hours or not. We assessed the SCIM score at 1 year after the operation as the functional outcome index. XGBoost was used to build a nonlinear regression prediction model through the method of boosting integrated learning.Results: We successfully constructed a nonlinear regression prediction model through XGBoost and verified the credibility. The average absolute value of the difference between the predicted value and the actual value is 3.72 (t=1.29, P=0.203), ranging from 0 to 8.44. AMS and age ranked first and second in predicting the functional outcome.Conclusion: We verified the feasibility of using XGBoost to construct a nonlinear regression prediction model for the functional outcome of patients with acute SCI, and we found that age and AMS play the most important role in predicting the functional outcome.Trial registration: ClinicalTrials.gov identifier: NCT03103516.

scholarly journals A Clinical Prediction Model for Long-Term Functional Outcome after Traumatic Spinal Cord Injury Based on Acute Clinical and Imaging Factors

2012 ◽  
Vol 29 (13) ◽  
pp. 2263-2271 ◽  
Author(s):  
Jefferson R. Wilson ◽  
Robert G. Grossman ◽  
Ralph F. Frankowski ◽  
Alexander Kiss ◽  
Aileen M. Davis ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Prediction Model ◽  
Functional Outcome ◽  
Traumatic Spinal Cord Injury ◽  
Clinical Prediction ◽  
Clinical Prediction Model ◽  
Cord Injury

scholarly journals Multivariate Analysis of Acute Magnetic Resonance Imaging Predicts Neurological Improvements in Patients With Cervical Spinal Cord Injury After Early Surgical Decompression

Neurosurgery ◽  
2019 ◽  
Vol 66 (Supplement_1) ◽  
Author(s):  
Tomoo Inoue ◽  
Toshiki Endo ◽  
Shinsuke Suzuki ◽  
Hiroshi Uenohara ◽  
Teiji Tominaga
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Magnetic Resonance ◽  
Mr Imaging ◽  
Spinal Injury ◽  
Cervical Spinal Cord ◽  
Principal Component ◽  
Surgical Decompression ◽  
Cervical Spinal Cord Injury ◽  
Cord Injury

Abstract INTRODUCTION Patients with cervical spinal cord injury (SCI) show different clinical outcomes. There is a significant association between the acute magnetic resonance (MR) imaging of cervical SCI and neurological recovery of cervical SCI. We speculated that principal component analysis (PCA), a dimension reduction procedure, would detect clinically predictive patterns in complex MR imaging and predict neurological improvements assessed by the American Spinal Injury Association Impairment Scale (AIS) and Japanese Orthopaedic Association (JOA) score. METHODS We performed a retrospective analysis of 50 patients with cervical SCI who underwent early surgical decompression less than 48 h after the trauma. We analyzed 7 types of MR imaging assessments: axial grade assessed by the Brain and Spinal Injury Center score (BASIC), longitudinal intramedurallry lesion length, spinal cord signal intensity on T1 and T2 weighted image, maximum canal compromise, maximum spinal cord compression, Subaxial Cervical Spine Injury Classification System. PCA was applied on these multivariate data to identify factors that contribute to recovery after cervical SCI following surgery. AIS conversion was evaluated at 6 mo. RESULTS Nonlinear principal component (PC) evaluation detected 2 features of MR imaging. PCA revealed PC 1 (40.6%) explaining the intramedullary signal abnormalities that were negatively associated with postoperative AIS conversion. PC2 (18.5%) suggested extrinsic morphological variables, but did not predict outcomes. The BASIC score revealed the significant overall predictive value for AIS conversion at six months (AUC 0.86). This result suggested that the intramedullary signal abnormalities reflect delayed neurological improvements even after early surgical decompressions in patients with cervical SCI. CONCLUSION PCA could be a useful data-mining tool to show the complex relationships between acute MR imaging findings in cervical SCI. This study emphasized the importance of multivariable intramedullary MR imaging as clinical outcome predictors.

scholarly journals Blood Serum Cytokines in Patients with Subacute Spinal Cord Injury: A Pilot Study to Search for Biomarkers of Injury Severity

2021 ◽  
Vol 11 (3) ◽  
pp. 322
Author(s):  
Sergei Ogurcov ◽  
Iliya Shulman ◽  
Ekaterina Garanina ◽  
Davran Sabirov ◽  
Irina Baichurina ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Pilot Study ◽  
Injury Severity ◽  
Spinal Injury ◽  
Neuron Specific Enolase ◽  
Enzyme Linked Immunosorbent Assay ◽  
Cord Injury ◽  
The Difference ◽  
Endothelial Growth Factor

Background. Despite considerable interest in the search for a spinal cord injury (SCI) therapy, there is a critical need to develop a panel of diagnostic biomarkers to determine injury severity. In this regard, there is a requirement for continuing research into the fundamental processes of neuroinflammatory and autoimmune reactions in SCI, identifying changes in the expression of cytokines. Methods. In this pilot study, an extended multiplex analysis of the cytokine profiles in the serum of patients at 2 weeks post-SCI (n = 28) was carried out, together with an additional assessment of neuron-specific enolase (NSE) and vascular endothelial growth factor (VEGF) levels by enzyme-linked immunosorbent assay. A total of 16 uninjured subjects were enrolled as controls. Results. The data obtained showed a large elevation of IFNγ (>52 fold), CCL27 (>13 fold), and CCL26 (>8 fold) 2 weeks after SCI. The levels of cytokines CXCL5, CCL11, CXCL11, IL10, TNFα, and MIF were different between patients with baseline American Spinal Injury Association Impairment Scale (AIS) grades of A or B, whilst IL2 (>2 fold) and MIP-3a (>6 fold) were significantly expressed in the cervical and thoracic regions. There was a trend towards increasing levels of NSE. However, the difference in NSE was lost when the patient set was segregated based on AIS group. Conclusions. Our pilot research demonstrates that serum concentrations of cytokines can be used as an affordable and rapid detection tool to accurately stratify SCI severity in patients.

A prediction model of functional outcome at 6 months using clinical findings of a person with traumatic spinal cord injury at 1 month after injury

Spinal Cord ◽  
2020 ◽  
Vol 58 (11) ◽  
pp. 1158-1165
Author(s):  
Yuto Ariji ◽  
Tetsuo Hayashi ◽  
Ryosuke Ideta ◽  
Ryuichiro Koga ◽  
Satoshi Murai ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Prediction Model ◽  
Functional Outcome ◽  
Clinical Findings ◽  
Traumatic Spinal Cord Injury ◽  
Cord Injury

scholarly journals Ultra-Early (<12 Hours) Surgery Correlates With Higher Rate of American Spinal Injury Association Impairment Scale Conversion After Cervical Spinal Cord Injury

Neurosurgery ◽  
2018 ◽  
Vol 85 (2) ◽  
pp. 199-203 ◽  
Author(s):  
John F Burke ◽  
John K Yue ◽  
Laura B Ngwenya ◽  
Ethan A Winkler ◽  
Jason F Talbott ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Spinal Injury ◽  
Cervical Spinal Cord ◽  
Surgical Decompression ◽  
Cervical Spinal Cord Injury ◽  
Optimal Time ◽  
American Spinal Injury Association ◽  
Early Group ◽  
Cord Injury

Abstract BACKGROUND Cervical spinal cord injury (SCI) is a devastating condition with very few treatment options. It remains unclear if early surgery correlated with conversion of American Spinal Injury Association Impairment Scale (AIS) grade A injuries to higher grades. OBJECTIVE To determine the optimal time to surgery after cervical SCI through retrospective analysis. METHODS We collected data from 48 patients with cervical SCI. Based on the time from Emergency Department (ED) presentation to surgical decompression, we grouped patients into ultra-early (decompression within 12 h of presentation), early (within 12-24 h), and late groups (&gt;24 h). We compared the improvement in AIS grade from admission to discharge, controlling for confounding factors such as AIS grade on admission, injury severity, and age. The mean time from injury to ED for this group of patients was 17 min. RESULTS Patients who received surgery within 12 h after presentation had a relative improvement in AIS grade from admission to discharge: the ultra-early group improved on average 1.3. AIS grades compared to 0.5 in the early group (P = .02). In addition, 88.8% of patients with an AIS grade A converted to a higher grade (AIS B or better) in the ultra-early group, compared to 38.4% in the early and late groups (P = .054). CONCLUSION These data suggest that surgical decompression after SCI that takes place within 12 h may lead to a relative improved neurological recovery compared to surgery that takes place after 12 h.

Active physiological conservative management in traumatic spinal cord injuries – an evidence-based approach

Trauma ◽  
2017 ◽  
Vol 19 (1_suppl) ◽  
pp. 10-22 ◽  
Author(s):  
W El Masri ◽  
Naveen Kumar
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Conservative Management ◽  
Spinal Cord Injuries ◽  
Spinal Injury ◽  
Surgical Decompression ◽  
The Body ◽  
Prognostic Indicators ◽  
Number Of Patients ◽  
Cord Injury

The management of the traumatic spinal cord injury remains controversial. Guttmann demonstrated that with simultaneous attention to all medical and non-medical effects of the spinal cord injury, a significant number of patients recovered motor and sensory functions to ambulate and the majority were pain-free following conservative management. Active physiological conservative management of the spinal injury requires simultaneous scrupulous care of the injured spine together with; the multisystem neurogenic effects of the spinal cord injury on the respiratory, cardiovascular, urinary, gastrointestinal, dermatological, sexual and reproductive functions; the management of the associated psychological effects of paralysis from the early hours or days of injury as well as; the physical rehabilitation and modification of the environment. To date, there is no evidence to suggest that the surgical decompression and/or stabilisation of the neurologically impaired spinal cord injury patient is advantageous. This article considers the debates and evidence of surgical management including the effects of timing of the surgical decompression. Also addressed are the factors influencing decisions on management, prognostic indicators of recovery and natural history of complete and incomplete cord injuries. Traumatic biomechanical instability of the spine, physiological instability of the spinal cord, traumatic spinal canal encroachment and traumatic cord compression are also discussed. Early mobilisation, indications for surgery at the RJAH and economic considerations of spinal cord injuries are presented. The ultimate goals of the active physiological conservative management are to ensure maximum neurological recovery and independence, a pain-free and flexible spine, safe and convenient functioning of the various systems of the body with minimal inconvenience to patients and the prevention of complications.

scholarly journals The Effect of Different Acupuncture Therapies on Neurological Recovery in Spinal Cord Injury: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials

2019 ◽  
Vol 2019 ◽  
pp. 1-12 ◽  
Author(s):  
Feng Xiong ◽  
Chenying Fu ◽  
Qing Zhang ◽  
Lihong Peng ◽  
Zejun Liang ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Daily Living ◽  
Spinal Injury ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Neural Function ◽  
Motor Score ◽  
Cord Injury ◽  
The Difference

Many acupuncture therapies were used to treat spinal cord injury (SCI) and its complications. The difference in efficacy among these therapies has not been assessed. To compare the efficacy of different acupuncture therapies for SCI, we searched databases (PubMed, Embase, Cochrane Library, CNKI, and WanFang) for relevant RCTs in both English and Chinese before June 2019 that reported the association between acupuncture therapies and SCI. The RCTs were categorized according to the location of the acupoints used in them. The neural function was assessed by American Spinal Injury Association (ASIA) motor score, and daily living ability was accessed by Modified Barthel Index (MBI) after SCI. In total, 22 trials involving 1644 participants were included. The pairwise meta-analysis and random effects model network meta-analysis were conducted. The results indicated that exercise combined with electro-acupuncture (EA) is superior to exercise without acupuncture in improving the ASIA motor score. EA was associated with a significantly higher improvement in the MBI score than exercise alone, except for EA of head + limbs and limbs. Additionally, EA on the head + back and back + front (chest and abdomen) rank the top in both increasing the ASIA motor score and the MBI score. Acupuncture can significantly increase motor function and daily living ability of individuals who suffer from SCI, especially acupuncture of the back + front or the head + back. The evidence supports acupuncture of the back + front or the head + back as an effective treatment for SCI.

scholarly journals Adult Spinal Cord Injury without Major Bone Injury: Effects of Surgical Decompression and Predictors of Neurological Outcomes in American Spinal Injury Association Impairment Scale A, B, or C

2021 ◽  
Vol 10 (5) ◽  
pp. 1106
Author(s):  
Bo-Ram Na ◽  
Hyoung-Yeon Seo
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Spinal Injury ◽  
Surgical Decompression ◽  
Lesion Length ◽  
Compression Rate ◽  
American Spinal Injury Association ◽  
Bone Injury ◽  
Cord Injury ◽  
Adult Spinal Cord

The cervical spine can be injured even in the absence of radiographic abnormality, and the best surgical treatment for adult spinal cord injury without bone injury is debated. The aim of this study was to retrospectively investigate the effect of surgical decompression for severe adult spinal cord injury without major bone injury and to establish predictors of good neurological outcome. We analyzed 11 patients who underwent surgical decompression in severe adult spinal cord injury without major bone injury patients classified as American Spinal Injury Association Impairment Scale (AIS) grade A, B, or C. Neurological assessments were performed using AIS at preoperative and postoperative 1-year follow-up. Radiological evaluations were performed using cervical magnetic resonance imaging (MRI) at preoperative. Seven cases were classified as AIS grade A; two cases as AIS grade B; and two cases as AIS grade C. Five of 11 (45.5%) patients showed improved neurological grade 1-year postoperatively. Intramedullary lesion length (IMLL) (p = 0.047) and compression rate (p = 0.045) had the most powerful effect on AIS grade conversion. This study shows that the fate of the injured spinal cord is determined at the time of the injury, but adequate decompression may have limited contribution to the recovery of neurological function. Compression rate and IMLL on MRI can be used as a predictor of neurological recovery.

Sign in / Sign up

Export Citation Format

Share Document