Anterior Release Internal Distraction and Posterior Spinal Fusion for Severe and Rigid Scoliosis
Bibliographic record
Abstract
STUDY DESIGN: Retrospective study. OBJECTIVE: To report on the results of anterior release, posterior internal distraction (with or without further distraction), and subsequent posterior spinal fusion for severe and rigid scoliosis. SUMMARY OF BACKGROUND DATA: For severe and rigid scoliosis, conventional procedures, such as posterior instrumentation combined with an anterior release, enable limited correction. Posterior vertebral column resection brings better correction but with a high rate of neurological complications or intraoperative neurological events. METHODS: A total of 15 patients with severe and rigid scoliosis who underwent anterior release, posterior internal distraction (with or without further distraction), and subsequent posterior spinal fusion were retrospectively reviewed after a minimum follow-up of 2 years. The radiographical parameters were evaluated, and clinical records were reviewed. RESULTS: The average number of anteriorly removed discs was 4.1. Average posterior fusion length comprised 14.3 vertebrae. Overall, internal distraction corrected the mean Cobb angle by 58.1% (from 105.1° to 44.2°) compared with the initial curve magnitude. The mean preoperative scoliosis of 105.1° was corrected to 27.5° (74.3% correction) at the most recent follow-up. The correction rate of the proximal thoracic and thoracolumbar or lumbar curves was 48.1% and 82.1%, respectively. The preoperative thoracic kyphosis of 62.3° was corrected to 33.8° at the most recent follow-up. The preoperative lumbar lordosis of -66.1° was corrected to -46.3° at the most recent follow-up. The mean preoperative coronal imbalance of 0.8 cm improved to 0.5 cm at the most recent follow-up, and sagittal imbalance of 0.3 cm improved to 0.2 cm. Transient dyspnea occurred in one patient after the initial surgery and subsequently resolved. Two patients complained of concave soft-tissue pain after the first distraction. There were no neurological complications. CONCLUSION: Anterior release, posterior internal distraction, and subsequent posterior spinal fusion provide an effective alternative for severe and rigid scoliosis. LEVEL OF EVIDENCE: 4.
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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 | 0.000 | 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".