title: Use of multivariate linear regression and support vector regression to predict functional outcome after surgery for cervical spondylotic myelopathy.
abstract: This study introduces the use of multivariate linear regression (MLR) and support vector regression (SVR) models to predict postoperative outcomes in a cohort of patients who underwent surgery for cervical spondylotic myelopathy (CSM). Currently, predicting outcomes after surgery for CSM remains a challenge. We recruited patients who had a diagnosis of CSM and required decompressive surgery with or without fusion. Fine motor function was tested preoperatively and postoperatively with a handgrip-based tracking device that has been previously validated, yielding mean absolute accuracy (MAA) results for two tracking tasks (sinusoidal and step). All patients completed Oswestry disability index (ODI) and modified Japanese Orthopaedic Association questionnaires preoperatively and postoperatively. Preoperative data was utilized in MLR and SVR models to predict postoperative ODI. Predictions were compared to the actual ODI scores with the coefficient of determination (R(2)) and mean absolute difference (MAD). From this, 20 patients met the inclusion criteria and completed follow-up at least 3 months after surgery. With the MLR model, a combination of the preoperative ODI score, preoperative MAA (step function), and symptom duration yielded the best prediction of postoperative ODI (R(2)=0.452; MAD=0.0887; p=1.17 × 10(-3)). With the SVR model, a combination of preoperative ODI score, preoperative MAA (sinusoidal function), and symptom duration yielded the best prediction of postoperative ODI (R(2)=0.932; MAD=0.0283; p=5.73 × 10(-12)). The SVR model was more accurate than the MLR model. The SVR can be used preoperatively in risk/benefit analysis and the decision to operate.
authors.affiliation: Department of Neurosurgery, University of California Los Angeles, 300 Stein Plaza, Suite 536, Los Angeles, CA 90095-6901, USA.
authors.forename: Haydn
authors.initials: H
authors.lastname: Hoffman
authors.affiliation: Department of Computer Science, University of California Los Angeles, Los Angeles, CA, USA; Wireless Health Institute, University of California Los Angeles, Los Angeles, CA, USA.
authors.forename: Sunghoon I
authors.initials: SI
authors.lastname: Lee
authors.affiliation: Department of Neurosurgery, University of California Los Angeles, 300 Stein Plaza, Suite 536, Los Angeles, CA 90095-6901, USA.
authors.forename: Jordan H
authors.initials: JH
authors.lastname: Garst
authors.affiliation: Department of Neurosurgery, University of California Los Angeles, 300 Stein Plaza, Suite 536, Los Angeles, CA 90095-6901, USA.
authors.forename: Derek S
authors.initials: DS
authors.lastname: Lu
authors.affiliation: Department of Neurosurgery, University of California Los Angeles, 300 Stein Plaza, Suite 536, Los Angeles, CA 90095-6901, USA.
authors.forename: Charles H
authors.initials: CH
authors.lastname: Li
authors.affiliation: Department of Neurosurgery, University of California Los Angeles, 300 Stein Plaza, Suite 536, Los Angeles, CA 90095-6901, USA.
authors.forename: Daniel T
authors.initials: DT
authors.lastname: Nagasawa
authors.affiliation: Department of Neurosurgery, University of California Los Angeles, 300 Stein Plaza, Suite 536, Los Angeles, CA 90095-6901, USA.
authors.forename: Nima
authors.initials: N
authors.lastname: Ghalehsari
authors.affiliation: Department of Neurosurgery, University of California Los Angeles, 300 Stein Plaza, Suite 536, Los Angeles, CA 90095-6901, USA.
authors.forename: Nima
authors.initials: N
authors.lastname: Jahanforouz
authors.affiliation: Department of Neurosurgery, University of California Los Angeles, 300 Stein Plaza, Suite 536, Los Angeles, CA 90095-6901, USA.
authors.forename: Mehrdad
authors.initials: M
authors.lastname: Razaghy
authors.affiliation: Department of Neurosurgery, University of California Los Angeles, 300 Stein Plaza, Suite 536, Los Angeles, CA 90095-6901, USA.
authors.forename: Marie
authors.initials: M
authors.lastname: Espinal
authors.affiliation: Department of Neurosurgery, University of California Los Angeles, 300 Stein Plaza, Suite 536, Los Angeles, CA 90095-6901, USA.
authors.forename: Amir
authors.initials: A
authors.lastname: Ghavamrezaii
authors.affiliation: Department of Neurosurgery, University of California Los Angeles, 300 Stein Plaza, Suite 536, Los Angeles, CA 90095-6901, USA.
authors.forename: Brian H
authors.initials: BH
authors.lastname: Paak
authors.affiliation: Department of Anesthesiology, University of California Los Angeles, Los Angeles, CA, USA.
authors.forename: Irene
authors.initials: I
authors.lastname: Wu
authors.affiliation: Department of Anesthesiology, University of California Los Angeles, Los Angeles, CA, USA; Wireless Health Institute, University of California Los Angeles, Los Angeles, CA, USA.
authors.forename: Majid
authors.initials: M
authors.lastname: Sarrafzadeh
authors.affiliation: Department of Neurosurgery, University of California Los Angeles, 300 Stein Plaza, Suite 536, Los Angeles, CA 90095-6901, USA; Wireless Health Institute, University of California Los Angeles, Los Angeles, CA, USA; Department of Orthopedic Surgery, University of California Los Angeles, Los Angeles, CA, USA; Neuromotor Recovery and Rehabilitation Center, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA; Brain Research Institute, University of California Los Angeles, Los Angeles, CA, USA. Electronic address: dclu@mednet.ucla.edu.
authors.forename: Daniel C
authors.initials: DC
authors.lastname: Lu
mesh_terms: D000328:Adult; D000368:Aged; D002574:Cervical Vertebrae / Q000601:surgery; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function; D013118:Spinal Cord Diseases / Q000601:surgery*; D055009:Spondylosis / Q000601:surgery*; D060388:Support Vector Machine
keywords: Cervical spondylotic myelopathy; Multivariate linear regression; Support vector regression; Surgical outcomes