Consult and kyphoplasty delay impacts on geriatric vertebral compression fracture outcomes
Bibliographic record
Abstract
To determine the association between the delay in a neurosurgical consultation and subsequent kyphoplasty following the radiological diagnosis of a vertebral compression fracture (VCF), and surgical outcomes. A retrospective cohort study was conducted on elderly patients (60 years or older) who underwent kyphoplasty at Hamilton Health Sciences (HHS) between 2012 and 2022, with a prior admission under Internal Medicine or non-spine-surgical specialties at HHS within two years prior to surgery. The primary outcomes were the progression of vertebral height loss and focal kyphotic deformity at diagnosis, prior to kyphoplasty, and post-kyphoplasty. The study included 108 patients (53.7 % female, 46.3 % male, mean age 70.5 years), with 119 surgeries. Thoracic and lumbar spine VCFs were present in 60 (55.6 %) and 76 (70.4 %) patients, respectively. A significant increase in vertebral height loss was observed before kyphoplasty (8.45 %; 95 % CI 4.70 % – 12.21 %, p < 0.0001) and a robust augmentation of vertebral height was observed after kyphoplasty (−6.81 %; 95 % CI −12.07 % – −1.55 %, p = 0.0122). However, no significant correlations were found between delay times and changes in vertebral height or focal kyphotic deformity. Delays in neurosurgical consultation and kyphoplasty do not significantly affect radiographic outcomes in elderly patients with VCF. Despite restoration of vertebral height loss, the timing of intervention post-diagnosis does not influence the radiographic outcomes studied. This finding emphasizes the need for timely patient care while suggesting that delayed treatment might not adversely affect certain key radiographic metrics in elderly VCF patients.
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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 | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 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 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".