The Modified Lateral Approach: Experience of a Single Center using an Alternative Technique to Conventional Transpedicular Percutaneous Vertebroplasty
Bibliographic record
Abstract
Objective: The objective of this study was to assess whether the placement of a needle more lateral to the pedicle while using a transpedicular approach compared to the conventional technique yields comparable or better vertebral body filling. Methods: Retrospective review of 134 thoracic and lumbar unipedicular vertebroplasties performed by a single radiologist (110 lateral and 24 classic). Vertebral bodies were divided into eight voxels on computed tomography and the percent of coverage was documented. 50% and 75% cement filling thresholds were defined as “efficient.” Complications were retrospectively collected. Chi-square (χ2) was used to compare the filling efficacy and rates of extravertebral cement leakage between the approaches. Bivariate analysis was performed to assess variables potentially influencing the efficacy. Results: There was no significant difference between the two approaches for 50% coverage (classic; n = 21 [87.5%] vs. lateral; n = 98 [89.1%], P = 0.8228). There was more efficient coverage >75% using the lateral approach (classic; n = 4 [16.7%] vs. lateral; n = 46 (41.8%), P = 0.0210). Vertebral body level (50.8% thoracic vs. 26.0% lumbar, P = 0.0031) and fracture type (45.6% pathological vs. 29.2% osteoporotic, P = 0.0444) were associated with 75% coverage. Three classic cases (12.5%) had extravertebral cement leakage versus 34 lateral cases (30.9%), which was not statistically significant (P = 0.0676). Other complications included one asymptomatic lung embolization using both approaches, one pedicular fracture using the classic approach, and one overnight admission for analgesia using the lateral approach. Conclusion: A modified lateral approach proved to be as safe and more effective in achieving 75% or more vertebral filling in treating compression fractures compared to the conventional approach.
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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 | 0.002 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 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".