Use of a Transpedicular Drill Guide for Pedicle Screw Insertion in the Thoracic Spine
Bibliographic record
Abstract
A transpedicular drill guide (TDG) was designed to assist in the safe placement of pedicle screws in the thoracic spine. In a preliminary study, pilot holes were drilled into the pedicles (T1 to T12) of eight anatomical models in order to compare the conventional anatomical technique to the TDG. Visual inspection of the drilled pedicles was performed. Subsequently in a cadaveric study, pilot holes were made using the TDG in the thoracic spine (T1 to T11) of one human cadaver before inserting 4.5 mm diameter screws. CT scan followed by visual inspection of the cadaveric spine was performed to evaluate the position of the screws. With the anatomical models, 19 of 96 (19.8%) holes drilled using the TDG and 64 of 96 (66.7%) holes drilled using the anatomical technique violated the pedicle wall (p<0.001). The TDG reduced the rate of medial perforation. Ninety-nine percent of the pilot holes made with the TDG were within 2 mm from the pedicle wall compared to 79.2% for the anatomical technique. In the cadaveric study, one of the 22 (4.5%) screws violated the medial wall of the right T1 pedicle by less than 1 mm. No screw penetrated the anterior vertebral cortex, nor the lateral, superior or inferior pedicle wall. The TDG is easy to use and can decrease the incidence of misplaced thoracic pedicle screws. The TDG could be used alone as an alternative to navigation systems in certain applications or with fluoroscopy during thoracic pedicle screw placement, especially for training surgeons.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.005 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".