Comparative Analysis of Surgical Approaches and Osteotomies for the Correction of Sagittal Plane Spinal Deformity in Adults
Bibliographic record
Abstract
STUDY DESIGN: A retrospective review. OBJECTIVE: To compare the radiographical and clinical profiles between 2 surgical approaches for the correction of sagittal plane spinal deformity. SUMMARY OF BACKGROUND DATA: Sagittal plane decompensation is the radiographical parameter that carries the greatest impact on adverse outcomes. Surgical correction methods are heterogeneous, and opposing views pervade the spine community in consideration of the most effective approach and techniques to achieve correction. METHODS: A total of 33 cases with sagittal spinal deformity were assessed according to their surgical approach, posterior only versus combined anteroposterior group. Comparison was based on the demographic data, and radiographical parameters included pelvic tilt, pelvic incidence, sacral slope, lumbar lordosis, thoracic kyphosis, and sagittal vertical axis. RESULTS: Twenty two subjects were identified for the posterior-only and 11 subjects for the anteroposterior group. Average age was 58.7 years in the posterior-only and 55.7 years for the combined approach. Preoperative mean sagittal vertical axis was 186.6 and 147.7 mm, for the posterior-only and combined approaches, respectively (P = 0.1). Preoperative mean pelvic tilt was 34.2° for the posterior-only and 36.9° for the combined approach group (P = 0.5). A greater operative time for the combined approach was significant, 535 versus 333 minutes for the posterior-only approach (P < 0.001). In the posterior-only group, 8 of 22 patients and 7 of 11 patients in the combined-approach cohort experienced a postoperative complication (P = 0.16). The average follow-up was 41.8 and 47.7 months for the posterior-only and combined approaches, respectively (P = 0.4). CONCLUSION: A posterior-only or combined surgical approach had comparable radiographical outcomes. Higher morbidity was significant in regard to operative time in the combined-approach group. Deciding on the approach best suited for achieving correction in the sagittal plane likely resides on the surgeon's experience and expertise.
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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 | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.003 | 0.003 |
| 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) | 0.002 | 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".