Association between pre-operative sagittal alignment and radiographic measures of decompression following cervical laminectomy: a retrospective cohort study
Why this work is in the frame
A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.
Bibliographic record
Abstract
BACKGROUND: The primary purpose of this study was to determine the association between pre-operative cervical sagittal alignment and the extent of cord decompression in the form of increased spinal cord width and cerebrospinal fluid (CSF) space in front of and behind the cord in patients undergoing laminectomy for cervical spondylotic myelopathy (CSM). Secondary objectives included an assessment of the correlation between increasing numbers of levels decompressed and the post-operative cervical spine sagittal alignment, the effect of laminectomy on the change in alignment, as well as effect of laminectomy on pre-existing spinal cord signal abnormality. METHODS: This retrospective cohort study included patients who underwent cervical laminectomies, without fusion, between 2015 and 2020. Chart review was used to collect baseline variables. Cervical sagittal alignment, width of the spinal cord, and the CSF space in-front and behind the cord was measured pre-operatively and post-operatively using magnetic resonance imaging (MRI) scans for each patient. The correlation between change in measured parameters and pre-operative cervical sagittal alignment was assessed using Spearman's correlation. RESULTS: Thirty-five patients were included. Average age was 65.29±10.98 years old. The majority of patients (80%) underwent laminectomies at 3-4 levels. Average pre-operative sagittal alignment determined by the Cobb angle was 6.05°±14.17°, while the average post-operative Cobb angle was 3.15°±16.64°. The change in Cobb angle was not statistically significant (P=0.998). Eleven patients (32%) had pre-operative kyphotic sagittal alignment. The average time from surgery to post-operative MRI scan was 20.44±13.18 months (range, 3-39; median, 18.5; IQR, 23.5). There was no statistically significant association between increasing levels of decompression and change in alignment (P=0.546). Cord signal abnormality persisted after decompression. There was a moderate correlation between lordotic pre-operative cervical sagittal alignment and change in space in-front of the cord (correlation coefficient 0.337, P=0.048) and change in cord width (correlation coefficient 0.388, P=0.021). CONCLUSIONS: Severity of pre-operative kyphotic sagittal alignment is associated with decreased spinal cord drift and extent of decompression. The pre-operative sagittal alignment is not significantly associated with the change in post-operative alignment. Increasing number of levels decompressed does not worsen a kyphotic cervical spine sagittal alignment.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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 | 0.002 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 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 it