The Effect of Post-Operative Complications in Complex Adult Spinal Deformity Surgery on Surgical Outcomes: an International, Large-scale, Prospective Multi-center Study
Bibliographic record
Abstract
Introduction This large-scale study aimed to determine the effect of non-neurological complications in complex adult spine deformity surgery upon post-operative functional/disability profiles. Methods This is an international prospective multi-center study involving 15 sites from North America, Europe, and Asia. Adult patients with severe spinal deformity were assessed at 6 weeks and 6 months post-operatively. Non-neurological complications were recorded and grouped into intraoperative events, minor and major complications. Post-operative functional/disability outcomes were evaluated by Oswestry Disability Index (ODI) and SRS-22 pre-operatively and at each follow-up ( Fig. 1 ). Results 269 subjects were included (68% women and 32% men; mean age: 57.8 years). There were no significant differences in pre-operative ODI and SRS-22 scores between patients with and without major complication. At 6 weeks and 6 months after surgery, patients with major complications had significantly worse ODI and SRS-22 scores compared with patients without major complications ( p < 0.005). Both groups with and without major complications showed statistically significant functional improvement 6 months after surgery ( p < 0.0001). Improvement in functional scores were similar in patients with and without intra-operative events and/or minor complications (p > 0.05). Conclusion Based on the largest, multi-center study addressing complex adult spine deformity patients, worse post-operative functional/disability profiles were noted up until 6 months follow-up in patients who experienced major complications than those that did not. Similar functional/disability profiles were noted in patients who experienced intra-operative or minor complications. This study further broadens the understanding of postoperative surgical outcomes, risk profiles, and clinical/patient expectations following such deformity surgeries. [Figure: see text]
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".