In recent years, machine learning (ML) and artificial neural networks (ANNs), a particular subset of ML, have been adopted by various areas of healthcare. A number of diagnostic and prognostic algorithms have been designed and implemented across a range of orthopaedic sub-specialties to date, with many positive results. However, the methodology of many of these studies is flawed, and few compare the use of ML with the current approach in clinical practice. Spinal surgery has advanced rapidly over the past three decades, particularly in the areas of implant technology, advanced surgical techniques, biologics, and enhanced recovery protocols. It is therefore regarded an innovative field. Inevitably, spinal surgeons will wish to incorporate ML into their practice should models prove effective in diagnostic or prognostic terms. The purpose of this article is to review published studies that describe the application of neural networks to spinal surgery and which actively compare ANN models to contemporary clinical standards allowing evaluation of their efficacy, accuracy, and relatability. It also explores some of the limitations of the technology, which act to constrain the widespread adoption of neural networks for diagnostic and prognostic use in spinal care. Finally, it describes the necessary considerations should institutions wish to incorporate ANNs into their practices. In doing so, the aim of this review is to provide a practical approach for spinal surgeons to understand the relevant aspects of neural networks. Cite this article: Bone Joint J 2021;103-B(9):1442-1448.

中文翻译：

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人工智能和人工神经网络在脊柱手术中的诊断和预后价值：叙述性评论。

近年来，机器学习 (ML) 和人工神经网络 (ANN) 是 ML 的一个特定子集，已被医疗保健的各个领域采用。迄今为止，已经在一系列骨科亚专业中设计和实施了许多诊断和预后算法，并取得了许多积极的结果。然而，许多这些研究的方法论是有缺陷的，很少有人将 ML 的使用与临床实践中的当前方法进行比较。在过去的三十年中，脊柱外科发展迅速，特别是在植入技术、先进外科技术、生物制剂和增强康复方案领域。因此，它被认为是一个创新领域。如果模型在诊断或预后方面证明有效，脊柱外科医生将不可避免地希望将 ML 纳入他们的实践中。本文的目的是回顾已发表的研究，这些研究描述了神经网络在脊柱手术中的应用，并积极将 ANN 模型与当代临床标准进行了比较，以评估其有效性、准确性和相关性。它还探讨了该技术的一些局限性，这些局限性限制了神经网络在脊柱护理中的诊断和预后用途的广泛采用。最后，它描述了如果机构希望将人工神经网络纳入其实践的必要考虑因素。这样做的目的是为脊柱外科医生提供一种实用的方法来了解神经网络的相关方面。引用这篇文章：它还探讨了该技术的一些局限性，这些局限性限制了神经网络在脊柱护理中的诊断和预后用途的广泛采用。最后，它描述了如果机构希望将人工神经网络纳入其实践的必要考虑因素。这样做的目的是为脊柱外科医生提供一种实用的方法来了解神经网络的相关方面。引用这篇文章：它还探讨了该技术的一些局限性，这些局限性限制了神经网络在脊柱护理中的诊断和预后用途的广泛采用。最后，它描述了如果机构希望将人工神经网络纳入其实践的必要考虑因素。这样做的目的是为脊柱外科医生提供一种实用的方法来了解神经网络的相关方面。引用这篇文章：骨关节 J  2021；103-B(9)：1442-1448。