Comparison of Pedicle Subtraction and Smith-Petersen Osteotomies in Correcting Thoracic Kyphosis When Closed With a Central Hook-Rod Construct
Bibliographic record
Abstract
In Brief Study Design. Retrospective analysis. Objective. To demonstrate the effectiveness of hook-rod constructs in closing thoracic osteotomies safely and effectively. Summary of Background Data. The outcomes of hook-rod instrumentation in osteotomies for the correction of kyphosis at the lumbar region of the spine have been described. Little literature exists on the outcomes at the thoracic level. Methods. The radiographs and clinical scores of 38 patients who underwent pedicle subtraction osteotomy or Smith-Petersen osteotomy in the thoracic spine with the osteotomies closed using a central rod were retrospectively reviewed. Measurements included osteotomy angle, thoracic kyphosis (T2–T12), and maximum kyphosis. Perioperative and long-term complications were reviewed. Results. Thirty-eight patients underwent thoracic level osteotomies. There were 8 males and 30 females with a mean age of 51.9 years (range, 18–76 yr) at the time of surgery. The mean construct length was 13.2 levels (4–25). Kyphosis correction was equal in the 2 groups. In the pedicle subtraction osteotomy group, a mean of 24.7° (4°–47°) correction was obtained through the osteotomies compared with 24.0° (9°–65°) in the Smith-Petersen osteotomy group. Correction per osteotomy was 23.7° (4°–47°) in the pedicle subtraction osteotomy group compared with 11.8° (2.8°–46.0°) in the Smith-Petersen osteotomy group. No difference in the amount of correction achieved at the different regions of the thoracic spine was observed with either type of osteotomy with central rod closure. Conclusion. Central hook-rod constructs provide a safe and effective means of closing thoracic osteotomies and result in good correction of rigid sagittal plane deformities. Level of Evidence: 4 Osteotomies in the thoracic spine for kyphosis are more challenging due to the risk to the spinal cord and the difficulty in closing the osteotomies. This study shows that closing thoracic level pedicle subtraction osteotomies and Smith-Petersen osteotomies can be performed safely and effectively with the use of a central hook-rod construct in the setting of neuromonitoring.
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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 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| 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".