Screw Position After Double-Rod Anterior Spinal Fusion in Idiopathic Scoliosis
Bibliographic record
Abstract
STUDY DESIGN: A retrospective evaluation of screw position after double-rod anterior spinal fusion in idiopathic scoliosis using computerized tomography (CT). OBJECTIVE: To evaluate screw position and complications related to screw position after double-rod anterior instrumentation in idiopathic scoliosis. SUMMARY OF BACKGROUND DATA: Anterior instrumentation and fusion in idiopathic scoliosis is gaining widespread use. However, no studies have been published regarding the accuracy of screw placement and screw-related complications in double-rod and double-screw anterior spinal fusion and instrumentation in idiopathic thoracolumbar scoliosis surgery. METHODS: CT examinations were performed after surgery in 17 patients with idiopathic scoliosis. At each instrumented level, the position of the screw and the plate relative to the spinal canal, relative to the neural foramen, and relative to the aorta was measured. Complications related to screw position were registered. RESULTS: A total of 189 screws in 17 patients were evaluated. Malposition occurred in 23% (16 patients) of the total number of screws. Three screws (2 patients) were partially in the spinal canal (1%). This resulted in pain in the right leg in 2 patients. However, electromyography showed no abnormalities. At three levels (3 patients), there was contact between the instrumentation and the aorta. However, no vascular complications occurred. A total of 113 screws (10 patients) were placed under fluoroscopic control and 76 screws (7 patients) were placed without use of fluoroscopy. Less screw malposition was observed in the group in which fluoroscopic control was used (19% vs. 30%, not significant). CONCLUSIONS: Screw placement in double-rod anterior spinal fusion in idiopathic scoliosis seems to be technically demanding, and the use of fluoroscopic control results in less frequent malposition. The risk of neurologic and vascular complications is low.
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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 | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 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".