Assessment of Spinal Flexibility in Adolescent Idiopathic Scoliosis
Bibliographic record
Abstract
STUDY DESIGN: Prospective evaluation of a new suspension test to determine curve flexibility in adolescent idiopathic scoliosis (AIS) in comparison with erect side-bending. OBJECTIVE: To verify whether the suspension is a better method than side-bending to estimate curve reducibility and to assess spine flexibility. SUMMARY OF BACKGROUND DATA: Spinal flexibility is a decisive biomechanical parameter for the planning of AIS surgery. Side-bending is often referred as the gold standard, but it has a low reproducibility and there is no agreement amongst surgeons about the most advantageous method to use. Even more, every technique evaluates reducibility instead of flexibility since the forces involved in the change in shape of the spine are not considered. METHODS: Eighteen patients scheduled for AIS surgery were studied. Preoperative radiological evaluation consisted of 4 radiographs: standing posteroanterior, left and right erect side-bending, and suspension. The side-bending and the suspension tests were compared on the basis of the apical vertebrae derotation and the scoliosis curve reduction. Frontal and axial flexibility indices, expressed as the ratio between the moment induced by the body weight and the reduction, were calculated from the suspension data. RESULTS: The average scoliosis curve reduction and apical vertebra derotation were 21 degrees (37%) and 3 degrees (12%), respectively for erect side-bending and 26 degrees (39%) and 7 degrees (28%), respectively for suspension. The erect side-bending test generated a larger curve reduction (P = 0.05) when considering the moderate curves only and the suspension test (P = 0.02) when considering the severe curves. The suspension test produced a larger axial derotation (P = 0.007) when considering all the curves. The average traction force during suspension was 306 N (187 N-377 N). The average estimation for the frontal flexibility index was 1.64 degrees/Nm (0.84-2.82) and 0.51 degrees/Nm (0.01-1.39) for the axial flexibility index. CONCLUSION: Results of this study demonstrate the feasibility to really evaluate the spine flexibility with the suspension test. The estimated flexibility values are realistic and similar to those reported in vitro. Suspension should be used in the future for spine flexibility assessment.
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How this classification was reachedexpand
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) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| 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 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 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 teacher head, 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".