Posterior Rotating Rod Reduction Strategy for Irreducible Atlantoaxial Subluxations With Congenital Odontoid Aplasia
Bibliographic record
Abstract
In Brief Study Design. Applying rotating rod techniques to reduce irreducible atlantoaxial dislocation. Objective. To spare the occipital-C1 motion by the strategy in reduction of before surgery irreducible atlantoaxial dislocation with obvious neurologic symptoms and congenital odontoid aplasia. Summary of Background Data. The treatment of atlantoaxial dislocation (AAD) is a challenging problem for most surgeons. Posterior surgical stabilization of C1 and C2 include C1–C2 transarticular screws, or C1 lateral with C2 pars screws. These constructs, however, are based on preoperative reductions. When preoperative skull reduction fails and myelopathic symptoms coexist, long-segment cervico-occipital fusion and decompression are usually the only practical choice. Methods. The authors explored a different surgical technique to spare the axial occipital joints by rotating rods in polyaxial C1, C3 lateral mass, and C2 pars screws, functioning as a lever analogue. Three before surgery irreducible AAD cases with obvious neurologic symptoms and congenital odontoid aplasia were successfully reduced and fused with this procedure. The authors used intraoperative somatosensory-evoked potential monitoring and intraoperative fluoroscopy. Preoperative skull traction was employed to distract and help extend the atlantoaxial complexes. Results. Three C1–C2 dislocations were reduced completely without any deterioration of neurologic signs. Cervical myelopathic symptoms recovered soon after the operation. No atlantoaxial subluxation recurred. They returned to their normal work and/or activities. Conclusion. The rotating rod strategy is a viable option to reduce and fuse C1–C3 for AAD with odontoid aplasia. It spares the occipital-C1 motion. The authors explored rotating rod reduction strategy in treating preoperatively irreducible atlantoaxial dislocation. Three cases with congenital odontoid aplasia were successfully reduced and fused. The rotating rod strategy is a viable option to reduce and fuse C1–C3, sparing the occipital-C1 motion for atlantoaxial dislocation with odontoid aplasia.
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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 | 0.000 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 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".