AB159. SOH24AB_033. Outcomes following spinal surgery in patients with Parkinson’s disease: a systematic review and meta-analysis
Bibliographic record
Abstract
Background: Parkinson’s disease (PD) patients represent challenging spinal surgery candidates due to associated deformity. This study consolidates the literature concerning spinal surgery outcomes in PD versus non-PD patients, to evaluate if PD predisposes patients to worse post-operative outcomes, so that treatment protocols can be optimised. Methods: A systematic review and meta-analysis was conducted of PubMed/Medline, Embase, and Google Scholar databases per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies of interest included comparative (PD vs. non-PD) cohorts undergoing spinal surgery. Post-operative clinical outcomes were collated and compared for significance between cohorts. All statistical analysis was performed using The R Project for Statistical Computing (version 4.1.2), with a P value of P<0.05 deemed statistically significant. Results: In total, 494,049 patients were included across the 7 studies. Of those, 485,374 (98.2%) were patients without PD (non-PD), while 8,675 (1.8%) patients had PD at time of surgery. The collective mean age was noted as 69.9 years (PD: 70.9 years vs. non-PD: 68.5 years). Comparatively, there were 209,761 males (PD: 4,526; non-PD: 205185) and 284,288 females (PD: 4,147; non-PD: 279,976). Overall, there were more post-operative complications in the PD cohort (P=0.02). PD-patients experienced more mechanical complications (P=0.03), surgical site infections (P<0.01), and trended towards increased rates of post-operative delirium (P=0.06) and revision surgeries (P=0.09). No difference existed between cohorts for mortality (P=0.42). Conclusions: Although more robust prospective studies are needed, the results of this study highlight the need for advanced wound care management in the postoperative period, both in-hospital and in the community, in addition to comprehensive multidisciplinary care from allied health professionals, with potential for the use of enhanced recovery after surgery (ERAS) protocols in PD-patients undergoing spine surgery.
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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 | 0.010 | 0.021 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.012 | 0.032 |
| Bibliometrics | 0.006 | 0.008 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.003 | 0.001 |
| Insufficient payload (model declined to judge) | 0.011 | 0.001 |
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".