Late-Onset Bowel Perforation and Iliac Artery Erosion After Prominent Anterior Spinal Instrumentation
Bibliographic record
Abstract
In Brief Study Design. Case report. Objective. To report a rare complication of anterior spine surgery and instrumentation. Summary of Background Data. Anterior spinal fusion and instrumentation are now frequently used for the treatment of a variety of complex spinal disorders. Several authors have discussed the complications of such procedures. Late perforation of large bowel along with erosion of major vessel after anterior spinal instrumentation is a rare occurrence. Methods. We present a case of 53-year-old woman who presented with unusual abdominal pain and bleeding of the rectum. She had undergone spine surgery for L5 burst fracture 5 years ago. A detailed evaluation showed perforation of rectosigmoid colon and erosion of left common iliac artery by the anterior spine implants. Results. The bowel was repaired and arterial reconstruction was done along with spine implant removal. The patient had complete recovery of symptoms after the treatment. Conclusion. Delayed visceral injury with anterior spine surgeries is rare. Early diagnosis is possible with a high degree of suspicion. Meticulous surgical techniques may avoid this complication. We are reporting an unusual case of delayed perforation of rectosigmoid colon and erosion of left common iliac artery after anterior spine surgery. The bowel was repaired and arterial reconstruction was done along with spine implant removal. Following of meticulous surgical instrumentation techniques and use of low-profile implants may avoid occurrence of these injuries.
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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 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.005 | 0.001 |
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".