Identification of Anterior Cervical Spinal Instrumentation Using A Smartphone Application Powered by Machine Learning.

Study design Cross-sectional Study. Objective The purpose of this study is to develop and validate a machine learning algorithm for the automated identification of ACDF plates from smartphone images of AP cervical spine radiographs. Summary of background data Identification of existing instrumentation is a critical step in planning revision surgery for anterior cervical discectomy and fusion (ACDF). Machine learning algorithms that are known to be adept at image classification may be applied to the problem of ACDF plate identification. Methods 402 smartphone images containing 15 different types of ACDF plates were gathered. 275 images (∼70%) were used to train and validate a convolution neural network (CNN) for classification of images from radiographs. 127 (∼30%) images were held out to test algorithm performance. Results The algorithm performed with an overall accuracy of 94.4% and 85.8% for top-3 and top-1 accuracy respectively. Overall positive predictive value, sensitivity, and f1-scores were 0.873, 0.858, and 0.855 respectively. Conclusion This algorithm demonstrates strong performance in the classification of ACDF plates from smartphone images and will be deployed as an accessible smartphone application for further evaluation, improvement, and eventual widespread use.Level of Evidence: 3.