{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T16:24:45Z","timestamp":1793895885231,"version":"4.8.0"},"reference-count":19,"publisher":"SAGE Publications","issue":"1_suppl","license":[{"start":{"date-parts":[[2024,2,1]],"date-time":"2024-02-01T00:00:00Z","timestamp":1706745600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002732","name":"AO Spine","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002732","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Global Spine Journal"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:sec>\n                    <jats:title>Study design<\/jats:title>\n                    <jats:p>Predictive algorithm via decision tree<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Artificial intelligence (AI) remain an emerging field and have not previously been used to guide therapeutic decision making in thoracolumbar burst fractures. Building such models may reduce the variability in treatment recommendations. The goal of this study was to build a mathematical prediction rule based upon radiographic variables to guide treatment decisions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Twenty-two surgeons from the AO Knowledge Forum Trauma reviewed 183 cases from the Spine TL A3\/A4 prospective study (classification, degree of certainty of posterior ligamentous complex (PLC) injury, use of M1 modifier, degree of comminution, treatment recommendation). Reviewers\u2019 regions were classified as Europe, North\/South America and Asia. Classification and regression trees were used to create models that would predict the treatment recommendation based upon radiographic variables. We applied the decision tree model which accounts for the possibility of non-normal distributions of data. Cross-validation technique as used to validate the multivariable analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The accuracy of the model was excellent at 82.4%. Variables included in the algorithm were certainty of PLC injury (%), degree of comminution (%), the use of M1 modifier and geographical regions. The algorithm showed that if a patient has a certainty of PLC injury over 57.5%, then there is a 97.0% chance of receiving surgery. If certainty of PLC injury was low and comminution was above 37.5%, a patient had 74.2% chance of receiving surgery in Europe and Asia vs 22.7% chance in North\/South America. Throughout the algorithm, the use of the M1 modifier increased the probability of receiving surgery by 21.4% on average.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study presents a predictive analytic algorithm to guide decision-making in the treatment of thoracolumbar burst fractures without neurological deficits. PLC injury assessment over 57.5% was highly predictive of receiving surgery (97.0%). A high degree of comminution resulted in a higher chance of receiving surgery in Europe or Asia vs North\/South America. Future studies could include clinical and other variables to enhance predictive ability or use machine learning for outcomes prediction in thoracolumbar burst fractures.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/21925682231203491","type":"journal-article","created":{"date-parts":[[2024,2,7]],"date-time":"2024-02-07T13:31:50Z","timestamp":1707312710000},"page":"56S-61S","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":14,"title":["Predictive Algorithm for Surgery Recommendation in Thoracolumbar Burst Fractures Without Neurological Deficits"],"prefix":"10.1177","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4520-6454","authenticated-orcid":false,"given":"Charlotte","family":"Dandurand","sequence":"first","affiliation":[{"name":"Combined Neurosurgical and Orthopedic Spine Program, Vancouver General Hospital, University of British Columbia, Vancouver, BC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nader","family":"Fallah","sequence":"additional","affiliation":[{"name":"Praxis Spinal Cord Institute, Vancouver, BC, Canada"},{"name":"Department of Medicine, University of British Columbia, Koerner Pavilion, UBC Hospital, Vancouver, BC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cumhur F.","family":"\u00d6ner","sequence":"additional","affiliation":[{"name":"University Medical Centers, Utrecht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard J.","family":"Bransford","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Sports Medicine, Harborview Medical Center, University of Washington, Seattle, WA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klaus","family":"Schnake","sequence":"additional","affiliation":[{"name":"Center for Spinal and Scoliosis Surgery, Department of Orthopedics and Traumatology, Paracelsus Private Medical University Nuremberg, Nuremberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander R.","family":"Vaccaro","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Rothman Institute, Thomas Jefferson University Hospital, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5320-5638","authenticated-orcid":false,"given":"Lorin M.","family":"Benneker","sequence":"additional","affiliation":[{"name":"Spine Unit, Sonnenhof Spital, University of Bern, Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1157-4889","authenticated-orcid":false,"given":"Emiliano","family":"Vialle","sequence":"additional","affiliation":[{"name":"Cajuru Hospital, Catholic University of Paran\u00e1, Curitiba, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory D.","family":"Schroeder","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Rothman Institute, Thomas Jefferson University Hospital, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6043-006X","authenticated-orcid":false,"given":"Shanmuganathan","family":"Rajasekaran","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Spine Surgery, Ganga Hospital, Coimbatore, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6177-7145","authenticated-orcid":false,"given":"Mohammad","family":"El-Skarkawi","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic and Trauma Surgery, Faculty of Medicine, Assiut University, Assiut, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5817-4909","authenticated-orcid":false,"given":"Rishi M.","family":"Kanna","sequence":"additional","affiliation":[{"name":"Spine Department of Orthopaedics and Spine Surgery, Ganga Hospital, Coimbatore, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5221-8288","authenticated-orcid":false,"given":"Mohamed","family":"Aly","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Prince Mohammed Bin Abdulaziz Hospital, Riyadh, Saudi Arabi"},{"name":"Department of Neurosurgery, Mansoura University, Mansoura, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3763-8767","authenticated-orcid":false,"given":"Martin","family":"Holas","sequence":"additional","affiliation":[{"name":"Klinika \u00darazovej Chirurgie SZU a FNsP F.D.Roosevelta, Bansk\u00e1 Bystrica, Slovakia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2152-5725","authenticated-orcid":false,"given":"Jose A","family":"Canseco","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Rothman Institute, Thomas Jefferson University Hospital, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sander","family":"Muijs","sequence":"additional","affiliation":[{"name":"University Medical Centers, Utrecht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5732-5402","authenticated-orcid":false,"given":"Eugen Cezar","family":"Popescu","sequence":"additional","affiliation":[{"name":"Emergency Hospital, Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin Wee","family":"Tee","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, National Trauma Research Institute (NTRI), The Alfred Hospital, Melbourne, VIC, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5684-7679","authenticated-orcid":false,"given":"Gaston","family":"Camino-Willhuber","sequence":"additional","affiliation":[{"name":"Orthopaedic and Traumatology Department, Institute of Orthopedics \u201cCarlos E. Ottolenghi\u201d Hospital Italiano de Buenos Aires, Buenos Aires, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2645-0483","authenticated-orcid":false,"given":"Andrei Fernandes","family":"Joaquim","sequence":"additional","affiliation":[{"name":"Neurosurgery Division, Department of Neurology, State University of Campinas, Campinas-Sao Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ory","family":"Keynan","sequence":"additional","affiliation":[{"name":"Rambam Health Care Campus, Haifa, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harvinder Singh","family":"Chhabra","sequence":"additional","affiliation":[{"name":"Sri Balaji Action Medical Institute, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4649-0610","authenticated-orcid":false,"given":"Sebastian","family":"Bigdon","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery and Traumatology, Inselspital, University Hospital, University of Bern, Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5179-4192","authenticated-orcid":false,"given":"Ulrich","family":"Spiegel","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Trauma Surgery and Plastic Surgery, University of Leipzig, Leipzig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcel F","family":"Dvorak","sequence":"additional","affiliation":[{"name":"Combined Neurosurgical and Orthopedic Spine Program, Vancouver General Hospital, University of British Columbia, Vancouver, BC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,2,7]]},"reference":[{"key":"bibr1-21925682231203491","doi-asserted-by":"publisher","DOI":"10.21037\/atm.2019.07.99"},{"key":"bibr2-21925682231203491","doi-asserted-by":"publisher","DOI":"10.3390\/medicina58080998"},{"key":"bibr3-21925682231203491","doi-asserted-by":"publisher","DOI":"10.1097\/01.bsd.0000180080.59559.45"},{"key":"bibr4-21925682231203491","doi-asserted-by":"publisher","DOI":"10.1097\/01.brs.0000182986.43345.cb"},{"key":"bibr5-21925682231203491","doi-asserted-by":"publisher","DOI":"10.1177\/21925682221129220"},{"key":"bibr6-21925682231203491","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2021.04.106"},{"key":"bibr7-21925682231203491","doi-asserted-by":"publisher","DOI":"10.1007\/s00256-012-1551-x"},{"key":"bibr8-21925682231203491","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-018-5712-z"},{"key":"bibr9-21925682231203491","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-011-1913-4"},{"key":"bibr10-21925682231203491","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-199408000-00014"},{"key":"bibr11-21925682231203491","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-010-1451-5"},{"key":"bibr12-21925682231203491","doi-asserted-by":"publisher","DOI":"10.1007\/s001130050507"},{"key":"bibr13-21925682231203491","doi-asserted-by":"publisher","DOI":"10.1007\/s001130050667"},{"key":"bibr14-21925682231203491","doi-asserted-by":"publisher","DOI":"10.1007\/s001130170089"},{"key":"bibr15-21925682231203491","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-200305000-00001"},{"key":"bibr16-21925682231203491","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.N.00226"},{"key":"bibr17-21925682231203491","doi-asserted-by":"publisher","DOI":"10.3171\/spi.2006.4.5.351"},{"key":"bibr18-21925682231203491","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-199306150-00003"},{"key":"bibr19-21925682231203491","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-198801000-00008"}],"container-title":["Global Spine Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/21925682231203491","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/21925682231203491","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/21925682231203491","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T07:16:07Z","timestamp":1777446967000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/21925682231203491"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2]]},"references-count":19,"journal-issue":{"issue":"1_suppl","published-print":{"date-parts":[[2024,2]]}},"alternative-id":["10.1177\/21925682231203491"],"URL":"https:\/\/doi.org\/10.1177\/21925682231203491","relation":{},"ISSN":["2192-5682","2192-5690"],"issn-type":[{"value":"2192-5682","type":"print"},{"value":"2192-5690","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,2]]}}}