Acute Noncontiguous Multiple-Level Thoracic Disc Herniations With Myelopathy
Bibliographic record
Abstract
In Brief Study Design. The case report of a 38-year-old man with a unique acute, triple-level, noncontiguous thoracic disc herniation (T6, T9–T10, and T11–T12), delayed onset of lower limb weakness, paresthesias below the T10 dermatome, and urinary dysfunction following minor trauma resulting from a motorcycle accident. Objectives. To present an unusual case of herniation that could involve ambiguous test results (imaging findings not necessarily correlated with severity of clinical manifestations). Summary of Background Data. Multiple-level symptomatic disc herniations of the thoracic spine are rare, and the reported cases are mostly of contiguous, two-level lesions with chronic clinical presentation. No case of acute three-level noncontiguous ruptured thoracic disc herniations with myelopathy has been reported. Methods. Through the left transthoracic approach, partial corpectomy, complete discectomy, and interbody fusion of the T9–T10 vertebrae were performed. The less prominent lesions of the T6 and T12–L1 vertebrae were left untreated. Results. Remarkable improvement of neurologic symptoms, including motor weakness and bladder dysfunction, was observed 1 week after operation. At 1-year follow-up, he could walk without aid and with a somewhat spastic gait. However, paresthesias below dermatome T12 persisted. The patient refused to accept the recommendation of further surgical decompression of the nerves at the T6 and T12–L1 vertebral lesions. Conclusion. Since the presentation of thoracic disc herniation is variable and difficult to correlate with imaging findings, decompression at all lesion levels in a patient with symptomatic multiple-level ruptured thoracic disc herniations may be necessary to achieve complete symptom relief and satisfactory results. A unique noncontiguous triple-level thoracic disc herniation at the T6, T9 -T10, and T12-L1 spinal vertebrae was surgically treated. The myelopathic symptoms (urinary bladder dysfunction and leg weakness) improved after the predominant T9 -T10 lesion was treated by discectomy and bone grafting. Some residual spastic gait and paresthesia over both legs persisted after surgery. Decompression at all lesion levels may be necessary to achieve complete symptom relief and satisfactory results.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 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".