CT-Myelogram Predictors of Outcome in Patients with Cervical Spondylotic Myelopathy: Results of a Systematic Review
Bibliographic record
Abstract
Introduction Magnetic resonance imaging (MRI) is used routinely to diagnose cervical spondylotic myelopathy (CSM). However, in cases where MRI is contraindicated, CT myelogram remains the preferable imaging modality for the diagnosis of CSM. There remains no confirmed consensus on the use of specific CT myelogram parameters and their relationship with regards to CSM disease severity, clinical presentation and prognosis after surgical treatment. The purpose of this study is to determine the CT myelogram imaging parameters in patients diagnosed with CSM that correlate with severity of CSM and predict postoperative patient outcome Materials and Methods An electronic database search was performed using Ovid Medline and Embase. CT mylogram studies investigating the correlation between imaging characteristics and CSM severity or postoperative outcomes were included. Two independent reviewers performed citation screening, selection, qualitative assessment and data extraction using an objective and blinded protocol. All authors involved in the study have no disclosures related to present study. No funding was needed for this study. Results We found no studies investigating the correlation between CT myelogram parameters and CSM severity. A total of 5 studies (402 patients) were included in this review and investigated the role of CT myelogram parameters in predicting outcome after surgical treatment. All studies were retrospective cohort studies. CT mylogram characteristics included the transverse area of the spinal cord at maximum level of compression, spinal canal narrowing, number of blocks, spinal canal diameter and flattening ratio. There is low evidence suggesting that patients with a transverse area of the spinal cord >30 mm2 at the level of maximum compression have better postoperative recovery and outcome. Conclusion Patients with greater transverse area of spinal cord at the level of maximum compression on CT myelogram are more likely to have better neurological outcome after surgery. There is insufficient evidence to suggest that any of the other CT mylogram parameters investigated are predictors of postoperative outcomes in patients with CSM.
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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 | 0.005 | 0.027 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.007 | 0.007 |
| Bibliometrics | 0.012 | 0.015 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 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".