Patterns of Collapse in Thoracolumbar Burst Fractures
Bibliographic record
Abstract
OBJECTIVE: Functional outcomes of neurologically intact patients with burst fractures may be dependent on final kyphosis at the end of treatment. Conservative treatment is indicated if an acceptable sagittal alignment of the spine can be anticipated. Thoracolumbar burst fractures are often grouped as a single entity where, in fact, anatomically distinct areas of the spine may behave differently owing to different biomechanical factors. The goal of this work was to evaluate differential behavior in terms of final kyphosis in anatomically distinct regions of the spine following stable burst fractures. METHODS: Prospective analysis of kyphosis in 60 patients treated conservatively for traumatic thoracolumbar burst fracture was conducted. Initial trauma supine radiographs were measured for initial kyphosis (Ki). Final kyphosis (Kf) in the upright patient was measured at the end of treatment. The Ki and Kf were plotted on a scatter graph; with use of linear regression analysis, a mathematical model was created to define a relationship between Ki and Kf based on anatomic level of the spine. RESULTS: The thoracolumbar spine behaved in two independent patterns with respect to Kf. Kf at the thoracolumbar junction (T11-L1) had a collapse pattern that could be approximated most accurately with the equation Kf = Ki + 0.5 Ki. At the midlumbar spine, L2-L3 level, a best-fit model for collapse was Kf = Ki + 4 degrees . CONCLUSION: In this cohort of patients, fractures that were categorized as "stable" and not requiring surgery were studied for the purpose of determining differential collapse patterns in anatomically distinct areas of the lumbar spine. We have demonstrated that the thoracolumbar junction and the midlumbar spine behave differently biomechanically and recommend that these two anatomic levels be studied independently for research purposes.
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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 | 0.000 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| 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 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".