The Clinical Importance of Lumbosacral Transitional Vertebra in Patients With Adolescent Idiopathic Scoliosis
Bibliographic record
Abstract
In Brief Study Design. Retrospective review of radiographs. Objective. The objective of this study was to (1) determine the prevalence of lumbosacral transitional vertebra (LSTV) with computed tomography (CT) and (2) correlate LSTV presence with lumbar disc degeneration at each level by magnetic resonance imaging. Summary of Background Data. LSTV is a frequently observed abnormality. Although its prevalence in patients with adolescent idiopathic scoliosis (AIS) has been shown, no studies have yet examined the clinical importance of LSTV in patients with AIS. Methods. This study included 385 consecutive patients who underwent surgery for AIS at a single center. Plain radiographs and CT scans were used to detect LSTV. Disc degeneration was analyzed at the L3–4, L4–5, and L5–S1 disc levels with magnetic resonance imaging. The difference in disc degeneration at each level by the presence of LSTV was also analyzed. The effect of lumbar curve type on the disc degeneration of each level was then determined. To minimize confounding factors, logistic regression analysis was performed. Results. The overall prevalence of LSTV in patients with AIS confirmed by CT scans was 12.2% (47/385). The proportion of grade II or more disc degeneration at the L4–5 level was higher in the LSTV(+) group than in the LSTV(−) group (29.8% vs.19.2%) although it was not statistically significant (P = 0.093). Large lumbar curves showed a positive correlation with disc degeneration at the L5–S1 level (P = 0.022). Conclusion. The prevalence of LSTV in patients with AIS was 12.2%. A trend of early degeneration in L4–5 level discs was found in patients with AIS with LSTV although it was not statistically confirmed. Disc degeneration at the L5–S1 level is related to a large lumbar curve. If patients with AIS with large lumbar curves have LSTV, consideration should be given to stopping the distal fusion at L3 instead of L4. Level of Evidence: 4 The prevalence of lumbosacral transitional vertebra in patients with adolescent idiopathic scoliosis was 12.2%. A trend of early degeneration in L4–5 level discs was found in patients with adolescent idiopathic scoliosis with lumbosacral transitional vertebra. Disc degeneration at the L5–S1 level is related to a large lumbar curve. This result could be helpful in selecting distal fusion level.
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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) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 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".