P.128 Percutaneous cortical screws: a novel approach to posterior spinal stabilization
Bibliographic record
Abstract
Background: Pedicle screw (PS) fixation is considered the gold-standard for spine stabilization. However, minimally invasive surgery (MIS) and cortical screw (CS) fixation have become commonplace. The biomechanical and safety profiles of CS compared to PS have yet to be determined. To our knowledge, this is the first study to describe a novel percutaneous CS approach and compare its safety and accuracy to PS fixation. Methods: Standard percutaneous PS fixation was performed using fluoroscopy from L1-L5 on one-side with percutaneous CS being placed on the other-side (10-instrumented PS and CS levels each). Anatomical confirmation and comparison of pedicle breach incidence was performed afterward via open dissection. Results: Dissection revealed no breaches of either construct. As such, no statistical comparison was possible. At one-level however, a CS was seen breaching the posterior-third lateral vertebral body under the superior end-plate. A couple of exposed screw threads were visualized well away from any entering and/or exiting foraminal or extra-spinal neurovascular structures. Conclusions: MIS and CS-based constructs are relatively new fixation techniques. We describe a novel percutaneous CS technique incorporating advantages of both MIS and CS-constructs. Although no difference was found in pedicle breach incidence, further study comparing these techniques and rigorous patient selection for application are necessary.
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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 | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| 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 | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 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".