Internal Stabilization of a Flexion-Distraction Injury of the Upper Cervical Spine of a Toddler
Bibliographic record
Abstract
In Brief Study Design. A case report and literature review. Objective. To present a new and simple technique of fixation without fusion of a rare unstable Salter-Harris type I injury in the upper cervical spine of a 23-month-old toddler. Summary of Background Data. Surgical treatment of unstable pediatric cervical spine injuries most commonly involves posterior fusion with internal fixation, usually posterior wiring. Methods. Detailed description of the surgical procedure carried out for fixating an unstable flexion-distraction injury in a 23-month-old toddler, with severe head injury and pneumothorax, is presented. Results. A rare unstable flexion-distraction injury in the upper cervical spine of a toddler was successfully treated with a posterior Number 2 Vicryl (polyglactin 910; ETHICON Division of Johnson & Johnson) suture fixation, with good healing of the ligaments and end plates, without fusion. Preservation of motion was achieved without obvious instability at 28 months postsurgery. Conclusion. In selected cases of cervical spine injuries in the young pediatric population, simple stabilization of the spine using degradable Number 2 Vicryl (polyglactin 910) sutures with minimal exposure can provide sufficient stability until healing occurs. Advantages are that fusion is avoided and motion preserved. Posterior fusion with internal fixation is the accepted surgical treatment of unstable cervical spine injury in children. A rare unstable injury of the upper cervical spine of a toddler, treated by a new technique of fixation, is presented. Limited exposure and Number 2 Vicryl (polyglactin 910) sutures stabilization without fusion were used. Stable cervical spine with preserved motion was evident at 28 months postsurgery.
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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 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 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".