Future Data Points to Implement in Adult Spinal Deformity Assessment for Artificial Intelligence Modeling Prediction: The Importance of the Biological Dimension

Sleiman Haddad; Javier Pizones; Riccardo Raganato; Michael M. Safaee; Justin K. Scheer; Ferran Pellisé; Christopher P. Ames

doi:10.14444/8502

Article Figures & Data

Tables

View popup

Table

Summary of future data points to implement in adult spinal deformity assessment for artificial intelligence modeling prediction.

Category	Category and Type of Markers	Measure	Findings or Significance
Frailty	Serological markers	General etabolism	Adiponectin
		Mitochondrial dysfunction	Mitochondrial transcription factor A
			DNA degradation
		Oxidative stress	Malondialdehyde
			Carbonyl
		Systemic inflammation	C-reactive protein
			IL-6
			TNF-α
	Clinical tests	SPPB	Standing balance on both feet, gait speed in a 4-m walk, and chair-stand repeated 5 times
		Gait speed	Total distance/time
		Timed up-and-go test	Rise from a standard armchair, walk to a marker 3 m away, turn, walk back, and sit down again
Aging and senescence	Serological markers	Epigenetic clocks	Complex mathematical modeling including DNA methylation and laboratory values that reflect organ function and inflammatory state including albumin, creatinine, glucose, and C-reactive protein
		Telomere length	Telomere length is regulated by an enzyme called telomerase, and the degree of shortening is proportional to the risk of common diseases of aging and mortality.
		-Omics	Transcriptomics, proteomics, and metabolomics analysis among other. Complex bioinformatics and advanced computing algorithms are required to perform the analysis of over 10,000 different protein expressions and circulating and excreted metabolites as well as oxidative stress
Sarcopenia	Radiological	MRI/CT	Fatty acid infiltration of paravertebral and psoas muscles
		MRI/ultrasonography	Femoral quadriceps area and volume
		DXA	Appendicular lean mass index
	Clinical tests	Muscle grip	Grip of dominant hand measured with a dynamometer
		SPPB
		Timed up-and-go test
		Gait speed
		Body mass index
	Immunohistological	Glycoprotein Dickkopf 3 (Dkk3)	Marker of age-related muscle atrophy
		Pax7	Transcription factor regulating the myogenic potential and function of satellite cells in muscle repair and regeneration, marker of proper cell function
		Sca-1 and PDGFRα	Markers of fibroadipogenic progenitor cells that are readily converted into adipocytes and lead to muscle fatty infiltrates
	Gross examination	Muscle fibers	Atrophic muscle fibers have smaller cytoplasmic volumes but intact cellular machinery
			Degenerated fibers have altered characteristics such as myophagocytosis and cellular infiltration, fiber splitting, and cytoplasmic disruptions.
Bone quality	Radiological markers	CT	Hounsfield units; high-resolution peripheral quantitative CT
		DXA	Bone density; trabecular bone score; hip-axis length, hip-strength analysis, and finite element analysis
		Ultrasound	Radiofrequency echographic multispectrometry
	Serological markers	Micro-RNA and long-noncoding RNA, especially miRNA-103a	Novel markers and targets for new therapies or interventions
	Immunohistological	Expression levels of runt-related transcription factor 2, osteocalcin, osteoprotegerin, and the receptor activator of nuclear factor kappa-B ligand.	Bone remodeling and preservation

Abbreviations: CT, computed tomography; DXA, dual-energy x-ray absorptiometry; IL-6, interleukin 6; MRI, magnetic resonance imaging; SPPB, short physical performance battery; TNF-alpha, tumour necrosis factor alpha.