Enhanced Capacity for Spontaneous Correction of Lumbar Curve in the Treatment of Major Thoracic–Compensatory C Modifier Lumbar Curve Pattern in Idiopathic Scoliosis
Bibliographic record
Abstract
In Brief Study Design. Retrospective radiographic review. Objective. To evaluate the outcome of maximal selective thoracic correction with controllable corrective forces provided by cantilevel bending technique (CBT) for idiopathic scoliosis (IS) in the presence of widely deviated compensatory lumbar curve. Summary of Background Data. Current intraoperative instrumentation and fusion techniques for selective fusion involve undercorrection of the thoracic curve while allowing for spontaneous lumbar curve correction and maintaining overall coronal balance. Since the lumbar curve is nonstructural and compensatory, procedures for selective thoracic fusion should approximate the best possible correction of thoracic curve such that resultant spontaneous lumbar curve correction and compensation is maximized. Methods. Thirty-seven consecutive IS patients with main thoracic compensatory minor “C” modifier lumbar curves underwent maximal selective thoracic correction by CBT at a single institution. Radiographs were analyzed before surgery, immediately after surgery, and at most recent follow-up (range, 2–6 years). Results. A mean 83% thoracic correction was closely matched by a 81% lumbar correction at most recent follow-up. The mean thoracic curve correction/flexibility ratio was 2.4. Enhanced capacity for spontaneous correction of lumbar curve was evidenced by the mean correction/flexibility ratio of 1.2. Spontaneous correction of lumbar apical translation occurred in all patients. Global coronal imbalance was common before surgery (mean, 11 mm), and remained similarly so after surgery (mean, 12 mm). Conclusion. Use of CBT facilitates 3-dimensional control of corrective forces and allows for maximum selective instrumentation-assisted thoracic and spontaneous lumbar curve correction in patients with Lenke 1C or 2C IS. Selective thoracic fusion for Lenke Type 1C or 2C idiopathic scoliosis curves can either enhance or impair the capacity for spontaneous compensation and correction of the lumbar curve. Use of cantilever bending technique facilitates 3-dimensional control of the corrective forces and allows for maximum selective instrumentation-assisted thoracic and spontaneous lumbar curve correction.
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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) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| 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) | 0.001 | 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".