C1—C2 Intra-articular Screw Fixation for Atlantoaxial Posterior Stabilization
Bibliographic record
Abstract
STUDY DESIGN: A trial of a new posterior stabilization technique for atlantoaxial instability and a report of preliminary results. OBJECTIVES: To describe a new posterior stabilization technique for atlantoxial instability. SUMMARY OF BACKGROUND DATA: Magerl's transarticular screw fixation is an accepted technique for rigid atlantoaxial stabilization, which reportedly has yielded many good clinical results. However, the technique is technically demanding and poses a risk of injury to the nerves and veins. METHODS: Eleven patients who had been treated with intra-articular screw fixation in combination with Halifax interlaminar clamp (OSTEONICS, Allendale, NJ) for atlantoaxial instability were observed. Results of their clinical examinations and biomechanical studies using resinous bones of a cervical spine model were reviewed. RESULTS: In all patients, occipital pain, neck pain, and neural deficit improved, and bony fusion with no correction loss was shown on radiography. To date, no vascular or neural complications have been found, and no instrumentation failures have occurred. In the biomechanical study, the Halifax with transarticular screw fixation had significantly greater flexion stiffness than the Halifax only or the Halifax with intra-articular screw fixation, but the torsion stiffness of the Halifax with intra-articular screw fixation was significantly greater than that of the other Halifax combinations. CONCLUSION: The preliminary results showed that this technique was effective in strengthening the rotational stability of the atlantoaxial fixation and was considered useful for atlantoaxial posterior stabilization.
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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 | 0.002 | 0.001 |
| Meta-epidemiology (narrow) | 0.002 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| 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".