Construction and Validation of a Preoperative Surgical Difficulty Prediction and Risk Stratification System for Posterior Spinal Deformity Correction Surgery Based on Machine Learning ‐ Multicenter Cohort Study
ABSTRACT Operative duration reflects surgical complexity and is valuable for perioperative planning. To predict prolonged operative time in posterior spinal deformity correction, we developed a preoperative machine‐learning model. Data from 162 patients across 11 hospitals were analyzed. Ten algorithms were trained and compared, and the best‐performing model was implemented as a web calculator. Boruta identified seven key predictors: interval from illness to surgery, fibrinogen, white blood cell count, activated partial thromboplastin time, American Society of Anesthesiologists class, albumin, and age. LightGBM showed the most consistent performance, achieving an AUC of approximately 0.70. SHAP analyses improved interpretability, and calibration and decision‐curve analyses indicated good calibration and net clinical benefit. We developed an interpretable, internally validated model to estimate operative duration in posterior spinal deformity surgery. The web calculator may support individualized planning and more efficient operating‐room resource allocation. Clinical Trial Registration: NCT05867732
Authors
- Hong Ding (ORCID: https://orcid.org/0000-0003-4422-9248)
- Yusi Zhang (ORCID: https://orcid.org/0000-0002-5147-3460)
- Hui Jiang (ORCID: https://orcid.org/0000-0002-1156-9046)
- Jialiang Zheng
- K. Wang
- W. Li
- Chengliang Yin (ORCID: https://orcid.org/0000-0001-8262-5749)
- B Chen (ORCID: https://orcid.org/0000-0002-2391-066X)
- Xin Zhou (ORCID: https://orcid.org/0000-0003-4399-7915)
- Wei Liu (ORCID: https://orcid.org/0000-0001-8211-034X)
- Qiang Liu (ORCID: https://orcid.org/0000-0001-6180-0376)
- Tongqing Luo
- Xubin Quan
- Weiheng He
- Anfa Chen
- Qizhong Xu
- Chan Xu (ORCID: https://orcid.org/0009-0001-4059-5737)
- Zhaohui Hu
- Xuewen Hou
- Xiangdong Xi
- Runmin Li
- Sen Gao
- Zhi‐Ri Tang
- Shi‐Nan Wu
- Jiali Yu
- Liang Chen
- Haopeng Luan
- Wei Huang
Institutions
- Sun Yat-sen University (CN)
- Jinan University (CN)
- Guangdong Medical College (CN)
- Xuzhou Medical College (CN)
- Second Military Medical University (CN)
- Shanghai Jiao Tong University (CN)
- Xiamen University (CN)
- University of Malaya (MY)
- Liuzhou General Hospital (CN)
- Sixth Affiliated Hospital of Sun Yat-sen University (CN)
- Xi'an Honghui Hospital (CN)
- Hubei Provincial Hospital of Traditional Chinese Medicine (CN)
- Integrated Chinese Medicine (China) (HK)
- Ningxia Hui Autonomous Region Peoples Hospital (CN)
- Intelligent Systems Research (United States) (US)
- Shandong Provincial Hospital (CN)
- First Affiliated Hospital of Xi'an Jiaotong University (CN)
- Dongguan People’s Hospital (CN)
- Fourth Affiliated Hospital of Guangxi Medical University (CN)
- Shanxi Provincial Institute of Chemical Industry (China) (CN)
- Shanghai Sixth People's Hospital (CN)
- Xian Yang Central Hospital (CN)
- Shanxi Academy of Medical Sciences (CN)
- Luoyang Orthopedic-Traumatological Hospital of Henan Province (CN)
- Shandong First Medical University (CN)
- Shenzhen Second People's Hospital (CN)
- The Fourth People's Hospital of Ningxia Hui Autonomous Region (CN)
- First Affiliated Hospital Zhejiang University (CN)
Publication Details
- Journal
- iMetaMed
- Published
- 2026-01-14
- DOI
- https://doi.org/10.1002/imm3.70023
- Primary Topic
- Scoliosis diagnosis and treatment
- Type
- article
- Field-Weighted Citation Impact
- 0.00