343 The Influence of Dynamic Data in Adult Spinal Deformity Surgery Planning and Patient Candidacy: A Preliminary Study

OBJECTIVES/GOALS: Adult spinal deformity is commonly treated by spine surgeons. Patient treatment planning and surgical candidacy are dependent on static measurements and inconsistent heuristics which lead to high complication rates and poor outcomes. This study tests the role of supplemental longit...

Full description

Bibliographic Details
Main Authors: Antony Fuleihan, Evan Haas, Siri Khalsa, John Williams, Youseph Yazdi, Nicholas Theodore
Format: Article
Language:English
Published: Cambridge University Press 2023-04-01
Series:Journal of Clinical and Translational Science
Online Access:https://www.cambridge.org/core/product/identifier/S2059866123003874/type/journal_article
_version_ 1797840475759050752
author Antony Fuleihan
Evan Haas
Siri Khalsa
John Williams
Youseph Yazdi
Nicholas Theodore
author_facet Antony Fuleihan
Evan Haas
Siri Khalsa
John Williams
Youseph Yazdi
Nicholas Theodore
author_sort Antony Fuleihan
collection DOAJ
description OBJECTIVES/GOALS: Adult spinal deformity is commonly treated by spine surgeons. Patient treatment planning and surgical candidacy are dependent on static measurements and inconsistent heuristics which lead to high complication rates and poor outcomes. This study tests the role of supplemental longitudinal and dynamic patient data in improving surgical planning. METHODS/STUDY POPULATION: Ten adult spinal deformity surgeons at Johns Hopkins Hospital were interviewed for 30 minutes by the study team. The script was reviewed by the institutional review board to alleviate any risk of bias. Two patient sets were curated utilizing previously treated, anonymized patient data sets from a non-surveyed practitioner. Each patient set was coupled with relevant radiographic imaging (MRIs, CTs, and plain radiographs) and pertinent clinical information that is collected in a standard clinic visit. Surgeons were presented with a patient and asked to note their specific surgical plan. Subsequently, surgeons were presented with four sets of supplemental dynamic spine data and asked to note their surgical plan for each set. Shaprio-Wilks and Mann-Whitney U tests were used to assess data normality and nonnormality. RESULTS/ANTICIPATED RESULTS: Preliminary data has shown inconsistency in both surgical selection and surgical type amongst physicians when presented with initial clinical findings and radiographic reports for base patient cases. There was minimal consensus among surgeons on the number of levels fused and interbody spacer usage. Early results show that dynamic spine data may be beneficial in creating consistency between surgeons, despite inter-surgeon variability in surgical planning without this data. Posture, pain location, pain severity, and quantified activity throughout the day have been referenced as the most useful dynamic spine data to consider. Amongst all providers, the availability of dynamic spine data resulted in a change in surgical planning. DISCUSSION/SIGNIFICANCE: Recent publications have shown that spine surgery patient candidacy and surgical planning are dependent on heuristics. This has led to inconsistencies amongst surgeon preferences and increases in improper patient selection for procedures. Incorporating longitudinal dynamic data may lead to increased consistency and improved patient outcomes.
first_indexed 2024-04-09T16:15:56Z
format Article
id doaj.art-5a753dcae52c4df48509082822bb6297
institution Directory Open Access Journal
issn 2059-8661
language English
last_indexed 2024-04-09T16:15:56Z
publishDate 2023-04-01
publisher Cambridge University Press
record_format Article
series Journal of Clinical and Translational Science
spelling doaj.art-5a753dcae52c4df48509082822bb62972023-04-24T05:55:54ZengCambridge University PressJournal of Clinical and Translational Science2059-86612023-04-01710210210.1017/cts.2023.387343 The Influence of Dynamic Data in Adult Spinal Deformity Surgery Planning and Patient Candidacy: A Preliminary StudyAntony Fuleihan0Evan Haas1Siri Khalsa2John Williams3Youseph Yazdi4Nicholas Theodore5Johns Hopkins University Center for BioEngineering Innovation and DesignJohns Hopkins University Center for BioEngineering Innovation and DesignJohns Hopkins Medicine Department of NeurosurgeryJohns Hopkins Medicine Department of NeurosurgeryJohns Hopkins University Center for BioEngineering Innovation and DesignJohns Hopkins University Center for BioEngineering Innovation and DesignOBJECTIVES/GOALS: Adult spinal deformity is commonly treated by spine surgeons. Patient treatment planning and surgical candidacy are dependent on static measurements and inconsistent heuristics which lead to high complication rates and poor outcomes. This study tests the role of supplemental longitudinal and dynamic patient data in improving surgical planning. METHODS/STUDY POPULATION: Ten adult spinal deformity surgeons at Johns Hopkins Hospital were interviewed for 30 minutes by the study team. The script was reviewed by the institutional review board to alleviate any risk of bias. Two patient sets were curated utilizing previously treated, anonymized patient data sets from a non-surveyed practitioner. Each patient set was coupled with relevant radiographic imaging (MRIs, CTs, and plain radiographs) and pertinent clinical information that is collected in a standard clinic visit. Surgeons were presented with a patient and asked to note their specific surgical plan. Subsequently, surgeons were presented with four sets of supplemental dynamic spine data and asked to note their surgical plan for each set. Shaprio-Wilks and Mann-Whitney U tests were used to assess data normality and nonnormality. RESULTS/ANTICIPATED RESULTS: Preliminary data has shown inconsistency in both surgical selection and surgical type amongst physicians when presented with initial clinical findings and radiographic reports for base patient cases. There was minimal consensus among surgeons on the number of levels fused and interbody spacer usage. Early results show that dynamic spine data may be beneficial in creating consistency between surgeons, despite inter-surgeon variability in surgical planning without this data. Posture, pain location, pain severity, and quantified activity throughout the day have been referenced as the most useful dynamic spine data to consider. Amongst all providers, the availability of dynamic spine data resulted in a change in surgical planning. DISCUSSION/SIGNIFICANCE: Recent publications have shown that spine surgery patient candidacy and surgical planning are dependent on heuristics. This has led to inconsistencies amongst surgeon preferences and increases in improper patient selection for procedures. Incorporating longitudinal dynamic data may lead to increased consistency and improved patient outcomes.https://www.cambridge.org/core/product/identifier/S2059866123003874/type/journal_article
spellingShingle Antony Fuleihan
Evan Haas
Siri Khalsa
John Williams
Youseph Yazdi
Nicholas Theodore
343 The Influence of Dynamic Data in Adult Spinal Deformity Surgery Planning and Patient Candidacy: A Preliminary Study
Journal of Clinical and Translational Science
title 343 The Influence of Dynamic Data in Adult Spinal Deformity Surgery Planning and Patient Candidacy: A Preliminary Study
title_full 343 The Influence of Dynamic Data in Adult Spinal Deformity Surgery Planning and Patient Candidacy: A Preliminary Study
title_fullStr 343 The Influence of Dynamic Data in Adult Spinal Deformity Surgery Planning and Patient Candidacy: A Preliminary Study
title_full_unstemmed 343 The Influence of Dynamic Data in Adult Spinal Deformity Surgery Planning and Patient Candidacy: A Preliminary Study
title_short 343 The Influence of Dynamic Data in Adult Spinal Deformity Surgery Planning and Patient Candidacy: A Preliminary Study
title_sort 343 the influence of dynamic data in adult spinal deformity surgery planning and patient candidacy a preliminary study
url https://www.cambridge.org/core/product/identifier/S2059866123003874/type/journal_article
work_keys_str_mv AT antonyfuleihan 343theinfluenceofdynamicdatainadultspinaldeformitysurgeryplanningandpatientcandidacyapreliminarystudy
AT evanhaas 343theinfluenceofdynamicdatainadultspinaldeformitysurgeryplanningandpatientcandidacyapreliminarystudy
AT sirikhalsa 343theinfluenceofdynamicdatainadultspinaldeformitysurgeryplanningandpatientcandidacyapreliminarystudy
AT johnwilliams 343theinfluenceofdynamicdatainadultspinaldeformitysurgeryplanningandpatientcandidacyapreliminarystudy
AT yousephyazdi 343theinfluenceofdynamicdatainadultspinaldeformitysurgeryplanningandpatientcandidacyapreliminarystudy
AT nicholastheodore 343theinfluenceofdynamicdatainadultspinaldeformitysurgeryplanningandpatientcandidacyapreliminarystudy