Treatment of Thoracolumbar Burst Fractures by Means of Anterior Fusion and Cage
Bibliographic record
Abstract
STUDY DESIGN: Retrospective case series. OBJECTIVE: To evaluate the outcome of treating acute thoracolumbar burst fractures using anterior corpectomy and reconstruction with a mesh cage and instrumentation. SUMMARY OF BACKGROUND DATA: There is increasing interest in using an anterior mesh cage with instrumentation after corpectomy for burst fractures. However, there is only limited information on this technique in the literature. METHODS: Twenty-two patients (mean age 37.6 y old) that had sustained a thoracolumbar burst fracture were included in this study. On admission, 20 patients (90.9%) had an incomplete neurological deficit. An anterior thoracolumbar approach was used to perform anterior corpectomy and reconstruction with a mesh cage and lateral fixation with screws and dual rods. We studied the operation date and delayed the blood loss, and we used the American Spinal Injury Association grade to evaluate the neurological status before surgery and in the follow-up period. Local kyphosis measured by the Cobb method was compared before and after the surgery using Wilcoxon signed-rank test/2-tailed test for analysis. RESULTS: Ninety percent of patients were operated within 2 days after admission and all were followed for a minimum of 25 months. The mean follow-up period was 47.4 months (range, 25 to 71 mo). Blood loss averaged 1445 mL. Of the 20 patients with incomplete neurological lesions, there were 6 (30%) patients with an improvement of at least 1 American Spinal Injury Association grade. No neurological deterioration was observed in any case. The local kyphosis measured by the Cobb method was improved from a mean of 15 degrees preoperative to a mean of 9.6 degrees in early postoperative period (P=0.002). The mean after 2 years was 11.5 degrees (P=0.011). There was no instrumentation failure. CONCLUSIONS: Anterior thoracolumbar decompression and fusion secured with an anterior mesh cage and instrumentation in thoracolumbar burst fractures provided excellent immediate reduction of post-traumatic local kyphosis.
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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 | 0.003 |
| 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) | 0.002 | 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".