rtificial intelligence (AI) algorithms have existed for decades and have recently been propelled to the forefront of medical imaging research. To a large extent, this is related to improvements in computing power, availability of a large amount of training data, and innovative and improved neural network architectures, with the recognition that certain types of algorithms are well suited to image analysis. The latter discovery was accelerated by the ImageNet competition and represents a fundamental transformation in research mechanics and methods in computer vision.Currently, in most studies, researchers collect data, perform analysis, and publish results. The same researchers may continue to augment and expand the data set and perform subsequent analysis with resulting publications. The data for each study are held quite closely and are rarely shared among institutions outside of multicenter trials. Competitions represent a different model of research: Research data are made available to the public, usually with a baseline performance metric. Groups around the world are invited to analyze the data and create algorithms to beat the performance of the prior generation. For example, the baseline performance metric for this challenge was set by the previous skeletal age model developed by Larson et al (1).The Radiological Society of North America (RSNA) Pediatric Bone Age Machine Learning Challenge was created to evaluate the performance of computer algorithms in executing a common image analysis activity that is familiar to many pediatric radiologists: estimating the bone age of pediatric patients based on radiographs of their hand (1-5). This challenge used a data set of pediatric
The purpose of this paper was to investigate the stand-alone lateral interbody fusion as a minimally invasive option for the treatment of low-grade degenerative spondylolisthesis with a minimum 24-month followup. Prospective nonrandomized observational single-center study. 52 consecutive patients (67.6 ± 10 y/o; 73.1% female; 27.4 ± 3.4 BMI) with single-level grade I/II single-level degenerative spondylolisthesis without significant spine instability were included. Fusion procedures were performed as retroperitoneal lateral transpsoas interbody fusions without screw supplementation. The procedures were performed in average 73.2 minutes and with less than 50cc blood loss. VAS and Oswestry scores showed lasting improvements in clinical outcomes (60% and 54.5% change, resp.). The vertebral slippage was reduced in 90.4% of cases from mean values of 15.1% preoperatively to 7.4% at 6-week followup (P < 0.001) and was maintained through 24 months (7.1%, P < 0.001). Segmental lordosis (P < 0.001) and disc height (P < 0.001) were improved in postop evaluations. Cage subsidence occurred in 9/52 cases (17%) and 7/52 cases (13%) spine levels needed revision surgery. At the 24-month evaluation, solid fusion was observed in 86.5% of the levels treated. The minimally invasive lateral approach has been shown to be a safe and reproducible technique to treat low-grade degenerative spondylolisthesis.
MRV should be used to assess patients with suspected IIH, and bilateral transverse sinus stenosis should be considered for the diagnosis. The stenosis classifying index proposed here is a fast and accessible method for diagnosing IIH.
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