Sequential Rod Rolling for Surgical Correction of Lenke Type 2 Adolescent Idiopathic Scoliosis: A 3D Analysis
Bibliographic record
Abstract
Introduction: Many options have been described to restore balance and create stable fusion in severe adolescent idiopathic scoliosis (AIS), including preoperative gravity halo traction, posterior vertebral column resection, and three column osteotomies. Unfortunately, each of these comes with risks of excess bleeding or neurological injury. The sequential rod rolling (SRR) technique uses a short stiff rod to distract and derotate the main thoracic (MT) curve, followed by a second full length rod on the opposite side to distract and derotate the proximal thoracic (PT) curve and finally a short rod on the convexity of the PT to offer a controlled correction of rigid deformities. The aim of this investigation is to describe the technique, its indications, the rotational correction achieved, and the complications observed when it is used in the treatment of severe pediatric AIS. Materials and Method: A retrospective study was carried out to include all patients treated with SRR to manage a Lenke 2 curve between 2006 and 2018, in whom a 3D EOS reconstruction was available. The primary objective of this study was to measure the derotation of the apical vertebra of the PT achieved by the sequential rod technique. The secondary objectives include defining the morbidity and complications observed. Results: Sixteen patients with a mean age of 15 years were included. The mean pre-operative coronal angular deformity was 53° for the PT and 76° for the MT. The mean post-operative coronal angular deformity was 19° for the PT, 22° for the MT. The mean rotation preoperatively was 10° for the apical vertebra of the PT and 23° for the MT. The mean rotation postoperatively was 3° for the apical vertebra of the PT and 8° for the MT. Twelve patients had a 2-year post-operative follow-up. No proximal junctional kyphosis or complications were reported at the 2-year follow-up. Conclusion: This data show that SRR achieves a mean coronal PT correction of 66% and 72% for the MT curve. The average derotation is 7° for the PT and 15° for the MT. No complications were encountered. The SRR technique for Lenke 2 type AIS seems to be, according this study a safe and effective technique.
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How this classification was reachedexpand
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 | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| 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 itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, 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".