A Review on the Use of Artificial Intelligence in Spinal Diseases

Artificial neural networks (ANNs) have been used in a wide variety of real-world applications and it emerges as a promising field across various branches of medicine. This review aims to identify the role of ANNs in spinal diseases. Literature were searched from electronic databases of Scopus and Medline from 1993 to 2020 with English publications reported on the application of ANNs in spinal diseases. The search strategy was set as the combinations of the following keywords: “artificial neural networks,” “spine,” “back pain,” “prognosis,” “grading,” “classification,” “prediction,” “segmentation,” “biomechanics,” “deep learning,” and “imaging.” The main findings of the included studies were summarized, with an emphasis on the recent advances in spinal diseases and its application in the diagnostic and prognostic procedures. According to the search strategy, a set of 3,653 articles were retrieved from Medline and Scopus databases. After careful evaluation of the abstracts, the full texts of 89 eligible papers were further examined, of which 79 articles satisfied the inclusion criteria of this review. Our review indicates several applications of ANNs in the management of spinal diseases including (1) diagnosis and assessment of spinal disease progression in the patients with low back pain, perioperative complications, and readmission rate following spine surgery; (2) enhancement of the clinically relevant information extracted from radiographic images to predict Pfirrmann grades, Modic changes, and spinal stenosis grades on magnetic resonance images automatically; (3) prediction of outcomes in lumbar spinal stenosis, lumbar disc herniation and patient-reported outcomes in lumbar fusion surgery, and preoperative planning and intraoperative assistance; and (4) its application in the biomechanical assessment of spinal diseases. The evidence suggests that ANNs can be successfully used for optimizing the diagnosis, prognosis and outcome prediction in spinal diseases. Therefore, incorporation of ANNs into spine clinical practice may improve clinical decision making.

[ predictive value of Japanese orthopaedic association score in patients diagnosed with lumbar disc herniation undergoing discectomy]

To study the predictive value of Japanese orthopaedic association [JOA] score in patients diagnosed with Lumbar disc herniation undergoing discectomy in many hospitals during 2008-2011. Patients diagnosed with lumbar disc herniation who were candidate for discectomy entered this cross sectional study. The Finneson and preoperative JOA scores were determined. Patients were recalled at least three months after surgery, and the result of discectomy were recorded based on DJOA [the difference between pre and postoperative JOA score]; in addition, patients' satisfaction were measured. Then the correlation coefficient and the linear relationship between the JOA score before surgery and the DJOA were found. Finally in a pilot study on 10 patients, the linear equation was evaluated. 117 patients were eligible to enter the study during the two years course of the study. Patients' mean age was 45 +/- 11 [18-82 y] and were followed for at least three months. The difference between pre and postoperative JOA score [18 +/- 5.2] was statistically significant [P<0.0001]. The correlation coefficient between the preoperative JOA score and DJOA was r=0.82. The linear relationship between preoperative JOA and DJOA was as follows: DJOA= -1.036 x preoperative JOA + 23.635. In a pilot study to estimate discectomy outcome, the correlation coefficient between the actual amount of DJOA and the estimated DJOA was r=0.88. It seems that the preoperative JOA is able to predict discectomy results in patients with lumbar disc herniation. A Longitudinal study in this area is recommended

Clinicopathological features of primary central nervous system lymphoma

To investigate the anatomic location, immunologic, and clinicopathological features of patients with primary central nervous system lymphoma [PCNSL]. From May 1993 to December 2004, at Shohada Hospital, Tehran, Iran, the clinical data of 110 PCNSL patients, including the age, sex, duration of symptoms, radiological findings, site of tumors, immune status, and history of immunocompromised state [such as organ transplantation, radiotherapy, steroid therapy or AIDS] were assessed. The mean age of the patients with PCNSL was 47.02 +/- 15.8 years. There were 42 female and 68 male patients. One hundred and six cases [96.3%] were diagnosed as B-cell lymphoma. Most of the PCNSL in our study are unifocal. More than 70% of tumors were in a cerebral hemisphere and periventricular location, usually involving the corpus callosum or basal ganglia. No patients had been in immunocompromised states. Symptoms of increased intracranial pressure or changes in personality, vision, or motor function are most common. Seizures are seen in approximately 10% of patients. The number of PCNSL cases showed a gradual rise in incidence. The results of this single hospital 12-year survey of PCNSL are in agreement with data from other single institutions and regional surveys concerning clinical features. However, in contrast with the literature, most of our patients were immunocompetent. The age at diagnosis is also lower than in most reports

Familial colloid cyst of the third ventricle: a case report and review of the literature

Familial colloid cyst of the third ventricle is very rare. This is one of the two largest families reported and the first in which all affected members are siblings. One asymptomatic sister was found by screening, emphasizing the value of screening. A brother and two sisters from a family consisting of three brothers and three sisters who were diagnosed as having colloid cyst of the third ventricle are presented. The index case like his sister underwent a tumor resection by middle frontal gyrus approach. Brain CT scan was performed for the other first degree family members for screening and colloid cyst was detected in another sister. When two or more members of a family are affected, screening has an important value for detecting other asymptomatic members with colloid cyst of the third ventricle