A Comparative Study of the Outcomes of Surgically Versus Non‐Surgically Treated Spinal Disease in Patients With Multiple Myeloma: Northern Ireland's Experience
Bibliographic record
Abstract
ABSTRACT Background Multiple myeloma is a haematological malignancy which is characterised by the proliferation of cancerous plasma cells in the bone marrow. The role of spinal surgery in the management of myeloma is debatable. Therefore, this retrospective study aimed to compare the outcomes of treatment of patients with myeloma whose spinal disease was managed surgically and/or non‐surgically. Methods A total of 159 patients were reviewed retrospectively. To compare the outcomes of treatment in both cohorts, three outcome measures were selected, including back‐pain reduction, neurological status, and survival duration. In addition, the extent and distribution of vertebral disease was assessed using MRI Whole Spine reports. Results There was no significant difference in the percentage of patients in each cohort reporting back‐pain pretreatment and at the two follow‐up periods ( p > 0.05). Regarding neurological status, 23% of the surgical cohort improved, 53% remained stable and 7% deteriorated. In comparison, the non‐surgical cohort displayed no significant changes in neurological status post‐treatment. The mean duration of survival was significantly longer in the cohort who received surgery (77 vs. 24 months, p = 0.014). However, the mean age of diagnosis was significantly lower in this cohort (59 vs. 71 years, p < 0.001). T12 was the most commonly diseased vertebral level across both cohorts. At the time of diagnosis, the average number of diseased vertebrae per patient was 3.5 in the surgical cohort and 3.6 in the non‐surgical cohort. Conclusion This comparative study has shown that back pain alone should not be an indication for spinal surgery. However, surgical intervention may successfully prevent neurological deterioration. Although surgical intervention is associated with prolonged survival, this may be confounded by demographic variables, such as age. Importantly, most patients displayed multi‐level disease at the time of diagnosis. Trial Registration: The authors have confirmed clinical trial registration is not needed for this submission.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 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 teacher head, 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".