Sacral Insufficiency Fractures Following Multilevel Instrumented Spinal Fusion
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Bibliographic record
Abstract
STUDY DESIGN: Case series. OBJECTIVE: To report a series of patients in whom sacral insufficiency fractures developed following multilevel spinal fusion with instrumentation. SUMMARY OF BACKGROUND DATA: Rigid spinal fusion with instrumentation results in abnormal distribution of forces in the spine. These forces have the potential to cause failure of adjacent segments, especially in older, osteopenic individuals. Sacral insufficiency fractures following lumbar-sacral fusion may be the result of these abnormal forces. However, this complication is not well described in the literature. METHODS: Three patients who sustained sacral fractures after instrumented lumbar-sacral fusion performed for degenerative disease of the spine are discussed. History, physical examination findings, and radiographic features are presented, along with a brief review of the pertinent literature. RESULTS: All 3 patients in our series started complaining of new-onset buttock pain a few weeks after their operative procedure. Radiographic examination revealed that they had transverse sacral fractures just below the fusion instrumentation. Nonoperative, conservative treatment was performed. At final follow-up, the fractures had healed completely and the patients' complaints had resolved. CONCLUSION: Patients who complain of new-onset buttock pain following multilevel lumbar-sacral fusion with instrumentation should be evaluated for sacral insufficiency fractures, especially if they have been sitting for prolonged periods. Conservative treatment seems to be sufficient.
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
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 it