Intralaminar Screw Insertion of Thoracic Spine in Children With Severe Spinal Deformities
Bibliographic record
Abstract
STUDY DESIGN: Case report. OBJECTIVE: To describe a technique of thoracic fixation in pediatric cases with anatomy not amenable to hooks and pedicle screws. SUMMARY OF BACKGROUND DATA: Intralaminar screws have been described in cervical and lumbar spines. There is only 1 report of the use of thoracic intralaminar screws being used for kyphotic deformity in adult patients. METHODS: We performed fixation of the thoracic spine using laminar screws in 2 patients with severe spinal deformities in whom pedicle screws and hooks failed to maintain the desired correction. Clinical and radiologic features of both cases are reported. The surgical technique is described. RESULTS: Intralaminar screws of the thoracic spine were successfully placed in 2 children with severe spinal deformities to achieve proximal fixation. Neither dorsal nor ventral cortical bone violations of the laminae were identified. In 1 case, pedicles were too small and sclerotic to accommodate pedicle screws. The second case was characterized by pedicle screw pull-out after corrective procedure, and the following revision with hooks caused fracture of the lamina. The intralaminar screws were subsequently used as proximal fixation to correct the deformity. No screw failure was encountered. Neither patient developed neurologic complications as a result of the screws. CONCLUSIONS: This procedure was used as a salvage technique in this series. However, our experience outlines the applicability of this technique at different thoracic levels and appears to be a useful tool in the armamentarium of the spinal surgeon dealing with patients with complex spinal deformities and difficult anatomy.
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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 | 0.004 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 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".