3dslicer-claude-bridge: Command for Claude Code

.claude/commands/instability-protocol.md

instability-protocol is a command for Claude Code from zhangreling02-ai/3dslicer-claude-bridge. It costs 0 tokens per session (1,023 once invoked), scanned A, original, MIT.

A medical-imaging command that checks whether parts of the spine move abnormally. It compares standing X-rays taken in a neutral position, while bending forward, and while bending backward, measuring shifting and angle changes at each level.

In plain words
What is it for?
Use it to assess instability at all loaded levels or at specified levels such as L4-L5 and L5-S1, using neutral, flexion, and extension X-rays.
Why use it?
It replaces manual comparison of three movement X-rays with a consistent measurement workflow and can add CT-based structural information.

Command for Claude Code

Written for Claude Code: installed under .claude/.

This is zhangreling02-ai/3dslicer-claude-bridge's own configuration. It tells Claude Code how to work on 3dslicer-claude-bridge itself, so it is not a mod to install elsewhere. Copy it as a starting point and replace the rules that are about this project. Everything 3dslicer-claude-bridge configures →

Reuse

Borrowing it

Nothing to install: this file belongs to zhangreling02-ai/3dslicer-claude-bridge. Take a copy, put it at the same path in your own repository, and replace the rules that are about this project with yours.

Copy the file
curl -O https://raw.githubusercontent.com/zhangreling02-ai/3dslicer-claude-bridge/main/.claude/commands/instability-protocol.md
Clone the repo
git clone --depth 1 https://github.com/zhangreling02-ai/3dslicer-claude-bridge

Made for: Claude Code.

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README.md
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Per session 0 Only the description is in the session, so the agent can decide to use it. The body loads when it is invoked.
When invoked 1,023 The whole file, excluding the scripts and references it only reads on demand.
Security scan A 0 findings. A grade says what 26 rules found in the file — not that it is safe.
Origin original No closer match found in the catalogue.
Token cost

What it costs to keep this loaded

Counted locally with the o200k_base tokenizer, which is exact for GPT models; Claude uses its own tokenizer and its counts differ. Treat this as one consistent yardstick across the catalogue rather than a bill. Prices are per million input tokens.

ModelPer sessionOnce invoked
Fable 5.1 $0.00000 $0.01023
Opus 5 $0.00000 $0.00511
Sonnet 5 $0.00000 $0.00205
Haiku 4.5 $0.00000 $0.00102

Measured 9d ago against content hash 8ad824836acb, method: parsed. Prices are Anthropic first-party input rates as of 2026-09-10, from the pricing page.

Security

Grade A, and why

instability-protocol scanned grade A with 0 findings against 26 rules in 11 categories — prompt injection, anti-refusal, data exfiltration, privilege escalation, supply chain, agent snooping, system-prompt leakage, SSRF and excessive agency — measured 9d ago.

A static scan of the body, not an audit. Every finding is printed with the line that produced it so you can judge whether it matters here. A mod is markdown that instructs an agent; that is exactly why what it instructs is worth reading.

Nothing flagged

None of the 26 patterns this scan looks for appear in this file: no shell pipes, no recursive deletes, no credential paths, no hidden text, no instruction-override or anti-refusal phrasing, no agent-config snooping. That is not a guarantee, it is the absence of the things that are checkable.

.claude/commands/instability-protocol.md · 131 lines

How it starts

The opening of the file, as written. The whole thing — 131 lines — stays where its author put it; the contents beside it link to each section on GitHub.

/instability-protocol - Segmental Instability Assessment

Dynamic instability evaluation using flexion-extension X-rays.

Description

Assesses segmental spinal instability by analyzing dynamic X-rays (neutral + flexion + extension). Measures translation and angular motion per level, applying White & Panjabi criteria. Optionally correlates with CT for structural assessment.

Usage

/instability-protocol                # Evaluate all loaded dynamic X-rays
/instability-protocol L4-L5 L5-S1   # Focus on specific levels

Instructions

When the user invokes this command:

1. Inventory available data

Call list_scene_nodes(). This protocol requires 3 X-ray volumes (neutral, flexion, extension). CT is optional but adds structural information.

Identify which volume is which. If unclear, ask the user:

Dynamic instability assessment requires 3 lateral X-rays:
  1. Neutral standing
  2. Maximum flexion
  3. Maximum extension

Please identify which loaded volume corresponds to each position:
[list loaded volumes]

2. Measure dynamic listhesis

measure_listhesis_dynamic_xray(
    neutral_volume_id=<neutral_id>,
    flexion_volume_id=<flexion_id>,
    extension_volume_id=<extension_id>,
    levels=<levels_if_specified>
)

3. CT correlation (if available)

If CT is loaded:

segment_spine(input_node_id=<ct_id>)

measure_listhesis_ct(
    volume_node_id=<ct_id>,
    segmentation_node_id=<seg_id>,
    levels=<levels>
)

If spondylolysis is detected on dynamic X-ray:

detect_vertebral_fractures_ct(
    volume_node_id=<ct_id>,
    segmentation_node_id=<seg_id>,
    region="lumbar"
)

And capture axial screenshots at the pars level:

capture_screenshot(view_type="axial")

4. Documentation

capture_screenshot(view_type="sagittal")   # Each position if possible

5. Generate instability report

SEGMENTAL INSTABILITY ASSESSMENT

DYNAMIC MEASUREMENTS:
  Level   | Position  | Translation | Trans %  | Seg Angle
  L4-L5   | Neutral   | 4.2mm       | 12.0%    | 10.5 deg
  L4-L5   | Flexion   | 8.1mm       | 23.1%    | 18.2 deg
  L4-L5   | Extension | 2.8mm       | 8.0%     | 5.1 deg

INSTABILITY ANALYSIS:
  Level   | Trans Range | Angle Range | Trans Unstable | Angle Unstable | Pattern
  L4-L5   | 5.3mm       | 13.1 deg    | YES (>4.5mm)   | YES (>11 deg)  | Combined
  L5-S1   | 1.2mm       | 6.3 deg     | NO             | NO             | Stable

Criteria applied: White & Panjabi
  - Lumbar translation threshold: 4.5mm
  - Lumbar angular motion threshold: 11 deg
  - Cervical translation threshold: 3.5mm
  - Cervical angular motion threshold: 11 deg

MEYERDING GRADING (maximum translation position):
  L4-L5: Grade I (23.1% in flexion)

SPONDYLOLYSIS:
  [Detected/Not detected]
  [If detected: bilateral/unilateral, pars gap mm]

CT CORRELATION (if available):
  Static listhesis: [values]
  Pars defect confirmation: [if applicable]
  Canal status: [if measured]

CLINICAL SUMMARY:
  Unstable levels: [list]
  Stable levels: [list]
  Pattern: [translational / angular / combined]
  Recommendation:
    - [Physical therapy / Facet block / Fusion]
    - [If spondylolysis + instability: "Consider direct pars repair vs fusion"]

Read the full file on GitHub · 131 lines

Changes

What this file has done since we first saw it

Hashed on every crawl. A supply-chain change to an agent config is a question of when, not whether, so the history is kept rather than the latest state alone.

  1. 9d ago First seen · 131 lines · 0 tokens per session scan A 8ad824836acb

Subscribe to this mod's changes

instability-protocol is a command published in the GitHub repository zhangreling02-ai/3dslicer-claude-bridge (0 stars, last pushed 6mo ago), licensed MIT. It costs nothing until one of its globs matches a file; then it loads 1,023 tokens. A static security scan graded it A with 0 findings. No closer match exists in the catalogue, so it is treated as the original; first seen 2026-08-31.