Medium Term Outcomes in Palliative Transpedicular Corpectomy with Cement Based Anterior Vertebral Reconstruction Performed for Patients with Spinal Metastasis
Bibliographic record
Abstract
STUDY DESIGN: Retrospective study. OBJECTIVE: The aim of this study was to assess the outcomes of single-stage posterior transpedicular corpectomy with cement-based anterior column support for spinal metastasis at longer follow-ups. SUMMARY OF BACKGROUND DATA: Life expectancy of cancer patients is constantly increasing. Reliable anterior column reconstruction after posterior corpectomy becomes necessary. MATERIALS AND METHODS: In this retrospective monocentric study, patients who underwent posterior transpedicular corpectomy and cement-based anterior reconstruction, with a minimum 6 months follow-up, were included. Ambulatory status and Pain Visual Analog Score (PVAS), complication rates, and local sagittal Cobb angle (LSA) were evaluated preoperatively, postoperatively, and at the latest follow-up. RESULTS: In total, 253 patients were included, with a mean follow-up of 21 months (6-132) and a median survival of 9 months. Preoperatively, 202 patients (81%) were ambulant, while 47 patients (19%) were not. At the latest follow-up, 241 patients (95%) were ambulant, while 12 patients (5%) were not ( P <0.001). Dorsal/lumbar PVAS went from 8.2±2.2 preoperatively to 5.2±1.7 postoperatively reaching 3.4±1.9 at the latest follow-up ( P <0.001). Mean LSA decreased from 13.2 (±5.78) degrees preoperatively to 6.11 (±8.51) degrees ( P <0.001) postoperatively and reached 7.56 (±7.55) degrees at the latest follow-up ( P =0.59). Complications occurred in 39 (15.4%) patients. One third of those were mechanical (rod/screw fracture, cement displacement) needing re-intervention in four patients (1.6%). CONCLUSIONS: The mechanical stability offered by the cement-based anterior reconstruction is maintained during the lifespan of patients operated for the spinal metastasis. Satisfying functional and radiologic outcomes observed at the last follow-up show that this lasting, cost sparing, and relatively simple reconstruction technique, is a valid alternative for the costly and more complicated cage-based reconstruction. LEVEL OF EVIDENCE: Level 4.
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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) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| 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) | 0.001 | 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".