Dynamic Positioning of Scoliotic Patients During Spine Instrumentation Surgery
Bibliographic record
Abstract
STUDY DESIGN: Evaluation of a novel Dynamic Positioning Frame (DPF) for scoliosis surgery to improve presurgical correction. OBJECTIVE: To assess a DPF for scoliosis surgery and demonstrate how its design offers additional presurgical correction of the 3-dimensional deformity. SUMMARY OF BACKGROUND DATA: Patient positioning is an important step in scoliosis surgery. Although current positioning frames focus on supporting the patient and keeping the abdomen pendulous to reduce blood loss, not much has been carried out to explore the aspect of dynamic positioning during surgery. When lying prone, there is some spontaneous correction of the scoliotic deformity owing to gravity and anesthesia. METHODS: Trunk 3-dimensional geometry and pressure at the patient-cushion interface were measured for 12 unanesthetized patients in various positions-standing (PI), lying prone on the DPF (PII), lying prone on the DPF with applied corrective forces (PIII), and lying prone on the Relton-Hall (R-H) frame for comparison (PIV). RESULTS: Spine height increased significantly in prone as compared with that in standing position. When lying on the DPF with corrective forces, there was an improvement in the patients' transverse plane deformity and rib hump with greater retention of kyphosis. There was also an improvement in the rib hump as compared with that in the R-H frame. Higher pressures were recorded on the DPF as compared with the R-H frame, but were reduced to similar values when larger cushions were used. CONCLUSIONS: The DPF provides a novel way of modifying the patient's position preoperatively and intraoperatively. Dynamic patient positioning, coupled with applied corrective forces, allows for increased reduction of the scoliotic deformity as compared with the R-H frame. Further investigation is required to optimize cushion placement and thus, insure safe patient-cushion interface pressures.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 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 teacher head, 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".