"Artificial Intelligence In Degenerative Lumbar Spine Management: Machine Learning Models For Data-Driven Clinical Decision-Making "
DOI:
https://doi.org/10.29284/vzt5sd88Keywords:
This study presents a machine learning model that accurately recommends appropriate treatments for lumbar degenerative disc disease, serving as a decision-support tool for spine surgeons. It also provides a valuable resource for resident doctors, enhancing their training and decision-making capabilities.Abstract
Background:
Artificial Intelligence (AI) is transforming medicine by enhancing diagnostic accuracy, treatment planning, and patient monitoring through advanced data analysis[1][2] [3].
We conducted a study at Narayana Health, Bangalore, to evaluate the utility of Machine Learning (ML) models—specifically Random Forest (RF), Support Vector Machine (SVM), and K-Nearest Neighbor (KNN)—in predicting and managing degenerative lumbar spine disease.
Objectives:
The aim of this study was to evaluate the potential of ML models in predicting and determining the appropriate treatment for degenerative lumbar spine disease. Additionally, we sought to explore how these models could assist neurosurgery and spinal surgery residents in the decision-making process during outpatient evaluations.
Methods:
Using retrospective data from 92 patients with degenerative lumbar spine disease, we identified 83 clinical and radiological parameters critical for preoperative evaluation. The models were trained on this dataset and validated using 20 new prospective cases. Assessment of treatment modalities—conservative management, surgical decompression, or decompression with fusion—were conducted by nine medical professionals, including four neuro-spinal surgeons and five neurosurgery residents.
Results:
RF and SVM models demonstrated superior accuracy, achieving 87.7%, significantly outperforming the KNN model. These models accurately predicted treatment modalities and outcomes, showing promise as decision-support tools.
Conclusions:
The RF and SVM models can complement clinical expertise and support training for spinal surgery residents, enhancing their learning in decision-making for degenerative lumbar spine disease. Future work will focus on expanding datasets, refining models, and exploring advanced ML techniques to optimize their application in education and patient care.
References
1. Fei Jiang, Yong Jiang, Hui Zhi, Yi Dong, Hao Li, Sufeng Ma, Yilong Wang, Qiang Dong, Haipeng Shen, Yongjun Wang. Artificial intelligence in healthcare: past, present and future: Stroke and Vascular Neurology. BMJ Journals. 2017; 2(4), 230–243. DOI: https://doi.org/10.1136/svn-2017-000101
2. Rushikesh S Joshi, Darryl Lau, Christopher P Ames. Machine learning in spine surgery: Predictive analytics, imaging applications and next steps, Seminars in Spine Surgery. Elsevier. 2021; 33(2),1–8. DOI: https://doi.org/10.1016/j.semss.2021.100878
3. Mohamed Khalifa, Mona Albadawy.AI in diagnostic imaging: Revolutionising accuracy and efficiency, Computer Methods and Programs in Biomedicine Update. Elsevier. 2024; 5,1–12. DOI: https://doi.org/10.1016/j.cmpbup.2024.100146.
4. Monika Halicka, Martin Wilby, Rui Duarte, Christopher Brown. Predicting patient-reported outcomes following lumbar spine surgery: development and external validation of multivariable prediction models. BMC musculoskeletal disorders. 2023; 24(1), 1–16. DOI: https://doi.org/10.1186/s12891-023-06446-2
5. Hernán Darío Vargas-Cardona, Mérida Rodriguez-Lopez, Marcela Arrivillaga, Carlos Vergara-Sanchez, Juan P García-Cifuentes, Paula C Bermúdez, Andres Jaramillo-Botero. Artificial intelligence forcervical cancer screening: Scoping review. The International Journal of Gynecology & Obstetrics. 2023;165(2),566–578. DOI:10.1002/ijgo.15179
6. Yiqian Zha, Cuili Xue, Yanlei Liu, Jian Ni, Jesus M De La Fuente, Daxiang Cui. Artificial intelligence in theranostics of gastric cancer, a review. De Gruyter. 2021; 3(3), 214–229. DOI: https://doi.org/10.1515/mr-2022-0042
7. Lorenz Adlung, Yotam Cohen, Uria Mor, Eran Elinav. Machine learning in clinical decision making. Cell Press. 2021; 2(6), 642–665. DOI: https://doi.org/10.1016/j.medj.2021.04.006
8. Li Ya-Wen, Liu Fang, Zhang Tian-Nan, Xu Fang, Gao Yu-Chen, Wu Tian. Artificial intelligence in pediatrics. Chinese medical journal. 2020; 133(3),358–360. DOI: https://doi.org/10.1097/CM9.0000000000000563
9. Jordan P Richardson, Cambray Smith, Susan Curtis, Sara Watson, Xuan Zhu, Barbara Barry, Richard R Sharp. Patient apprehensions about the use of artificial intelligence in healthcare. npj Digit. Med. 2021;4(1), 1–6. DOI: https://doi.org/10.1038/s41746-021-00509-1
10. Wireko Andrew Awuah, Favour Tope Adebusoye, Jack Wellington, Lian David, Abdus Salam, Amanda Leong Weng Yee, Edouard Lansiaux, Rohan Yarlagadda, Tulika Garg, Toufik Abdul-Rahman, Jacob Kalmanovich, Goshen David Miteu, Mrinmoy Kundu, Nikitina Iryna Mykolaivna. Recent Outcomes and Challenges of Artificial Intelligence, Machine Learning, and Deep Learning in Neurosurgery. World Neurosurgery.2024;23,1–9. DOI: https://doi.org/10.1016/j.wnsx.2024.100301
11. Alowais S A, Alghamdi S S, Alsuhebany N, Alqahtani T, Alshaya A I, Almohareb S N, Aldairem A, Alrashed M, Bin Saleh K, Badreldin H A, Al Yami M S, Al Harbi S, Albekairy A M. Revolutionizing healthcare: the role of artificial intelligence in clinical practice. BMC medical education. 2023; 23(1), 689. DOI: https://doi.org/10.1186/s12909-023-04698-z
12. Sushanta Kumar Das, Ramesh Kumari Dasgupta, Saumendu Deb Roy, Dibyendu Shil. AI in Indian healthcare: From roadmap to reality. Intelligent Pharmacy.2024;2(3),329-334. DOI: https://doi.org/10.1016/j.ipha.2024.02.005.
13. Uddin S, Khan A, Hossain M E, Moni M A. Comparing different supervised machine learning algorithms for disease prediction. BMC medical informatics and decision making.2019;19(1),281. DOI: https://doi.org/10.1186/s12911-019-1004-8
14. Beatriz Remeseiro, Veronica Bolon-Canedo. A review of feature selection methods in medical applications. Computers in Biology and Medicine. 2019,112, 1-9. DOI: https://doi.org/10.1016/j.compbiomed.2019.103375.
15. Kushchayev S V, Glushko T, Jarraya M et al. ABCs of the degenerative spine. Insights Imaging. 2018; 9, 253–274. DOI: https://doi.org/10.1007/s13244-017-0584-z
16. Jackins V, Vimal S, Kaliappan M et al. AI-based smart prediction of clinical disease using random forest classifier and Naive Bayes. J Supercomput. 2021; 77, 5198–5219. DOI: https://doi.org/10.1007/s11227-020-03481-x
17. Mahajan P, Uddin S, Hajati F et al. A comparative evaluation of machine learning ensemble approaches for disease prediction using multiple datasets. Health Technol.2024; 14, 597–613. DOI: https://doi.org/10.1007/s12553-024-00835-w
18. Fairbank JC, Pynsent PB. The Oswestry Disability Index. Spine (Phila Pa 1976) PubMed. 2000;25(22):2940-52. DOI:10.1097/00007632-200011150-00017
19. Naqvi U, Sherman AL. Muscle Strength Grading. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025. https://www.ncbi.nlm.nih.gov/books/NBK436008/
20. H Kenneth Walker, W Dallas Hall, J Willis Hurst. Deep Tendon Reflexes. Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition. Boston: Butterworths.1990; Chapter 72. https://www.ncbi.nlm.nih.gov/books/NBK396/
21. Camino Willhuber GO, Piuzzi NS. Straight Leg Raise Test. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025. https://pubmed.ncbi.nlm.nih.gov/30969539/
22. Urrutia J, Besa P, Campos M, Cikutovic P, Cabezon M, Molina M, Cruz JP. The Pfirrmann classification of lumbar intervertebral disc degeneration: an independent inter- and intra-observer agreement assessment. Eur Spine J. 2016; 25(9):2728-33. DOI: 10.1007/s00586-016-4438-z
23. Lee S, Lee JW, Yeom JS, Kim KJ, Kim HJ, Chung SK, Kang HS. A practical MRI grading system for lumbar foraminal stenosis. AJR American Journal for Roentgenology. 2010;194(4):1095-8. DOI: 10.2214/AJR.09.2772
24. Koslosky E, Gendelberg D. Classification in Brief: The Meyerding Classification System of Spondylolisthesis. Clin Orthop Relat Res. 2020; 478(5), 1125-1130. DOI: 10.1097/CORR.0000000000001153
25. Sriselvakumar S, Worsley C, Feger J, et al. Weishaupt grading system of lumbar facet joint degeneration. Radiopaedia.org.2025. DOI: https://doi.org/10.53347/rID-158404
Downloads
Published
Issue
Section
License

This work is licensed under a Creative Commons Attribution 4.0 International License.
This work is licensed under a Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

