European Spine Journal最新文献

{"title":"Does disc consistency matter? a comparative series on calcified and soft thoracic disc herniations.","authors":"Chinedu Egu, R M Prasanna S Ratnayake, Ibrahim M Alrabi, Nalinda S Jayalath, Neel Badhe, Eduardo Muscogliati, Weronika Nocun, Nasir A Quraishi, Elie Najjar","doi":"10.1007/s00586-025-09069-4","DOIUrl":"https://doi.org/10.1007/s00586-025-09069-4","url":null,"abstract":"","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144316284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical vs non-surgical management of adolescent idiopathic scoliosis: a 10-year narrative review of health-related quality of life and radiographic progression in 3315 patients.","authors":"Shuhao Zhang, Liancheng Wang, Yue He, Zeya Li, Guanchao Zuo, Shuai Wang, Jiangpeng Jia, Yongxia Wang","doi":"10.1007/s00586-025-08991-x","DOIUrl":"https://doi.org/10.1007/s00586-025-08991-x","url":null,"abstract":"<p><strong>Objective: </strong>To systematically collect, assess, and integrate relevant studies with a follow-up period of at least 10 years to explore the long-term prognosis and influencing factors in patients with adolescent idiopathic scoliosis (AIS).</p><p><strong>Methods: </strong>A literature search was conducted in PubMed, Embase, The Cochrane Library, Web of Science, Scopus, CNKI, and the Chinese Biomedical Literature Database regarding the long-term prognosis of AIS related to surgical and non-surgical treatments. The search period extended from the inception of each database to July 2024. The Newcastle-Ottawa Scale (NOS) was used to evaluate the quality of the included studies, and relevant data were extracted.</p><p><strong>Results: </strong>A total of 45 articles were included, covering 3, 315 AIS patients across 15 countries, with the highest number of publications originating from Japan. Most articles were published between 2015 and 2023. Specifically, 30 papers reported on the long-term prognosis of AIS patients who underwent surgical treatment, while 11 articles focused on the long-term prognosis of non-surgical treatments; an additional 4 studies compared the long-term effects of surgical versus non-surgical treatments. Treatment strategies for AIS patients included observation, bracing, exercise therapy, and surgery, with outcome measures primarily focusing on health-related quality of life (HRQoL) and disease progression.</p><p><strong>Conclusion: </strong>The contemporary therapeutic strategies involving the selection between surgical and non-surgical treatments yields comparable HRQoL and long-term functional outcomes at a follow-up duration exceeding 10 years in both patient cohorts.Surgical treatment has a positive effect on improving long-term prognosis, although some corrective loss is observed, resulting in overall stable outcomes. Non-surgical treatment has limitations in long-term correction effects; however, the HRQoL of patients remains largely unaffected.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144324928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Weight change patterns following surgery for cervical spondylosis in overweight and obese individuals: a nationwide longitudinal study.","authors":"Victor Gabriel El-Hajj, Marcus Roland Victor Gustafsson, Blake Clement, Victor E Staartjes, Mohamad Bydon, Paul Gerdhem, Adrian Elmi-Terander, Erik Edström","doi":"10.1007/s00586-025-09070-x","DOIUrl":"https://doi.org/10.1007/s00586-025-09070-x","url":null,"abstract":"<p><strong>Introduction: </strong>Cervical spondylosis may cause pain and disability, which leads to reduced activity levels and subsequent weight gains in affected patients. Surgical treatment of cervical spondylosis has been shown to improve quality of life and restore physical activity levels.</p><p><strong>Objective: </strong>We hence hypothesized that surgery in obese and overweight patients may lead to significant weight loss by means of pain and disability reduction as well as restoration of physical activity. This study aims to investigate whether surgery for cervical spondylosis leads to postoperative weight changes in overweight and obese patients.</p><p><strong>Methods: </strong>This is a retrospective longitudinal cohort study using prospective data. Obese and overweight patients who underwent surgery for cervical spondylosis in Sweden from 2005 to 2020, using the Swedish National Spine Register (SweSpine). Weight and BMI at both 1- and 2-years postoperatively were included in the analysis. Significant postoperative weight loss was considered as a loss of ≥ 5% of the initial preoperative weight and was the primary outcome of the study.</p><p><strong>Results: </strong>Of the 4,231 patients included in the main analysis, 32% were obese and 68% overweight. At 1-year follow-up, 25% of obese and 15% of overweight patients showed significant weight loss (≥ 5%, average 7 kg), increasing to 28% and 19% respectively by 2 years (p < 0.001). Younger patients (< 60 years) were more likely to lose significant weight at 1 year compared to older patients (20% vs. 16%, p = 0.005). Predictors of significant weight loss included obesity (OR: 1.87), NDI (OR: 1.01), NRS arm pain score (OR: 1.03), and NRS neck pain score (OR: 1.03), while male sex was linked to a lower likelihood of weight loss (OR: 0.74).</p><p><strong>Discussion: </strong>In conclusion, this study indicates that cervical spondylosis surgery may be associated with significant weight loss, particularly in younger and obese patients. Other predictors included higher preoperative pain and disability levels and female sex. Nonetheless, significant weight loss only occurred in a minority of patients. Future research should investigate the impact of a multidisciplinary approach on weight management and further examine additional predictive factors influencing weight loss.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144324929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The influence of sarcopenia on clinical and radiological features in patients with single-segment degenerative lumbar spondylolisthesis at L4/5 level.","authors":"Tianshu Feng, Congyu Wang, Xinyu Yang, Jinghang Li, Jinbo Zhao, Shuo Wang, Xinyu Liu, Lianlei Wang","doi":"10.1007/s00586-025-09050-1","DOIUrl":"10.1007/s00586-025-09050-1","url":null,"abstract":"<p><strong>Purpose: </strong>Sarcopenia may be related to more severe clinical and radiological features; however, its influence on the patients with single-segment DLS at L4/5 level remains unclear. In the study, the impact of sarcopenia on clinical and radiological factors were investigated in patients with L4/5 degenerative lumbar spondylolisthesis (DLS).</p><p><strong>Materials and methods: </strong>Patients diagnosed with single-segment DLS at L4/5 level were enrolled in the retrospective analysis based on a prospective, nonrandomized cohort dataset. According to our diagnostic process of sarcopenia, patients were classified into sarcopenia and non-sarcopenia groups. Clinical features including demographic characteristics, patient-reported outcome measures (PROMs) and clinician- reported outcome measures (ClinROMs) were collected. The radiological features included slip segment, percentage of slip (Slip%), translational motion, angular motion, dural sac cross-sectional area (DSA), ligamentum flavum thickness (LFT), paraspinal muscle parameters, and the use of grading systems to evaluate intervertebral discs, facet joints, and ligament degeneration.</p><p><strong>Results: </strong>A total of 161 individuals were included, with 44 in the sarcopenia group and 117 in the non-sarcopenia group. Statistical analysis indicated that patients with sarcopenia exhibited significantly lower height, weight, body mass index (BMI), pain duration of back and leg, DSA, Japanese Orthopaedic Association scores (JOA), relative functional cross-sectional area (rfCSA) of psoas (PS) and erector spinae (ES) (P < 0.05). Additionally, the proportion of female, Oswestry Disability Index (ODI), LFT, Pfirrmann grading, percentage of fat infiltration (FI%) of ES in the sarcopenia group were significantly higher (P < 0.05). Multivariate logistic regression analysis showed a significant association between sarcopenia and ODI (OR 0.934, 95% CI 0.899-0.972), Slip% (OR 0.874, 95% CI 0.776-0.986), LFT (OR 0.501, 95% CI 0.288-0.872), and rfCSA of ES (OR 1.571, 95% CI 1.128-2.187).</p><p><strong>Conclusion: </strong>Single-segment DLS patients at L4/5 level with sarcopenia suffered from greater pain and function impairment. In addition, more severe vertebral slippage and spinal stenosis were found, which may be linked to the degeneration of paraspinal muscles, intervertebral discs, and ligamentum flavum.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144316288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disc bulging predicts poor outcomes of decompression surgery for lumbar spinal canal stenosis.","authors":"Kyohei Kin, Akira Kusumegi, Masashi Chinen, Shohei Okamoto, Toshiharu Mitsuhashi, Yuichi Takahashi, Kenki Nishida","doi":"10.1007/s00586-025-09066-7","DOIUrl":"https://doi.org/10.1007/s00586-025-09066-7","url":null,"abstract":"<p><strong>Purpose: </strong>Lumbar spinal canal stenosis (LSCS) is a prevalent degenerative musculoskeletal disorder in aging populations. While decompression surgery is a standard treatment, some patients require revision surgery. Disc bulging, a distinct component of the degenerative process separate from disc herniation, contributes to spinal stenosis. However, its impact on surgical outcomes for LSCS has never been examined. This study aimed to elucidate the influence of disc bulging on outcomes of decompressive surgery for LSCS, addressing a critical knowledge gap.</p><p><strong>Methods: </strong>This retrospective study analyzed the clinical data of 517 consecutive patients involving 912 intervertebral levels who underwent decompression surgery for LSCS. We statistically evaluated the association between disc bulging and revision surgery. Two measures were utilized to assess disc bulging: the extended area of the disc (EAD), referring to the horizontal expansion of the disc, and the disc bulging length (DBL), which indicated the degree of disc intrusion into the spinal canal. Other conventional radiographical assessments and patient background characteristics were also evaluated.</p><p><strong>Results: </strong>Revision surgery was required in 28 patients (5.4%) involving 31 intervertebral levels (3.4%). Patients requiring revision surgery were significantly younger and more likely to smoke. Both the EAD and DBL were significantly higher in the revision group compared to the no-revision group (P <.001 for both). We did not observe an association between other conventional radiographical assessments and revision surgery. Multivariable analysis revealed that the EAD and DBL were independently correlated with revision surgery.</p><p><strong>Conclusion: </strong>This study demonstrated that disc bulging, particularly as measured by EAD, is a significant predictor of revision surgery following decompression for LSCS. These findings highlight the importance of pre-operative assessment of disc bulging in predicting surgical outcomes and optimizing patient selection for decompressive procedures.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144316283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The CASINO trial: surgical versus conservative management in patients with cervical radiculopathy due to intervertebral disc herniation: a prospective cohort study.","authors":"Azra Gül, Sarita van Geest, Barbara Kuijper, Anton Adriaan van der Plas, Ewout Steyerberg, Carmen Vleggeert-Lankamp","doi":"10.1007/s00586-025-09045-y","DOIUrl":"https://doi.org/10.1007/s00586-025-09045-y","url":null,"abstract":"<p><strong>Purpose: </strong>Cervical Radicular Syndrome is predominantly treated conservatively, but surgical treatment can be considered after shared decision-making. Knowledge about difference in outcome is scarce. The CASINO trial aims to enhance this knowledge to assist patients and physicians in optimizing treatment choices.</p><p><strong>Methods: </strong>A multi-centre observational cohort study was conducted in patients visiting a neurologist or neurosurgeon with CRS and disc-herniation. Conservative and surgical treatment were discussed and in agreement a decision was made. 141 patients with cervical radiculopathy due to intervertebral disc herniations were included, 88 were surgically and 53 were conservatively treated. Visual Analogue Scale for arm pain and Neck Disability Index served as primary outcome parameters. Secondary outcome measures involved VAS neck pain and the EuroQol VAS. Data were collected at baseline, 6, 12, 26, 38, 52 and 104 weeks after inclusion, and analysed using linear mixed-effects models.</p><p><strong>Results: </strong>At baseline, the surgical treatment-arm had more arm pain (VAS Arm Pain, p =.017) but other baseline parameters were comparable. However, during the two years follow up period the surgical arm fared better than the conservatively treated patients: VAS arm pain decreased 12 mm more in the surgical group than in the conservative group (p =.053), exceeding the Minimal Clinical Important Difference (MCID). VAS neck pain decreased 19 mm more in the surgical group than in the conservative group (p =.002), illustrating a significant and clinically relevant difference between the treatment arms.</p><p><strong>Conclusion: </strong>During two years follow up, differences could be substantiated between the two treatment arms regarding arm and neck pain.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144316287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence and risk factors investigation of chylous leakage following thoracic or lumbar vertebrectomy: a single‑center, retrospective analysis of 545 patients.","authors":"Fu-Sheng Liu, Xiao-Bin Wang, Qi-Mu Tang, Jing Li, Qian-Shi Zhang, Jia-Rui Hu, Bing Wang, Fu-Bing Liu","doi":"10.1007/s00586-025-09068-5","DOIUrl":"https://doi.org/10.1007/s00586-025-09068-5","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;Thoracic or lumbar vertebrectomy is a complex spinal surgical procedure associated with considerable invasiveness and a high incidence of complications, including the infrequent chylous leakage. This study seeks to document the incidence of chylous leakage following thoracic or lumbar vertebrectomy and to investigate the risk factors associated with this complication, thereby offering insights into its prevention and management.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A retrospective analysis was performed with patients who underwent thoracic or lumbar vertebrectomy at our institution between July 2016 and March 2024. The patients who developed postoperative chylous leakage were incorporated into the chylous leakage group, and its incidence rate was determined. A subset of patients who underwent thoracic or lumbar vertebrectomy during the same surgical month as the chylous leakage cases while did not develop this complication were selected as control group. Comparative analyses of demographic variables, including gender, age, and surgical excised segments, were conducted between the two groups. Additionally, perioperative data, such as operation duration, blood loss, length of hospital stay, clinical outcomes, and radiological follow-up, were evaluated. Statistical analyses, including chi-square tests, Fisher's exact test, and t-tests, were employed to investigate the risk factors associated with chylous leakage following thoracic or lumbar vertebrectomy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The study included a total of 545 patients who underwent thoracic or lumbar vertebrectomy, among whom 5 cases of chylous leakage were identified, corresponding to an incidence rate of 0.92%. The control group comprised 29 patients. No significant statistical differences were observed between the chylous leakage group and the control group regarding demographic characteristics. However, analysis of radiological and perioperative data indicated that the thickness of peri-lesion soft tissues was significantly greater in the chylous leakage group compared to the control group (16.58 ± 9.95 mm vs. 10.36 ± 5.19 mm, P = 0.04). Furthermore, the surgical excised segments were predominantly located between T10-L2, with a statistically significant difference compared to the control group (P = 0.039). Other parameters, including blood loss, transfusion volume, operation duration, surgical approach, and reconstruction methods, did not exhibit significant differences. One patient with chylous leakage developed a wound infection and received debridement with drainage. Other cases of chylous leakage were managed conservatively and resolved successfully.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Thoracic or lumbar vertebrectomy presents a risk of compromising the lymphatic system, potentially resulting in chylous leakage, especially in patients exhibiting over-thickened peri-lesion soft tissues or excised segments at the thoracolumbar region. Enhanced vigilance is ","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144316285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A cross-sectional association study of paravertebral muscle quality and modic changes in patients with chronic nonspecific low back pain.","authors":"Ningning Feng, Shuyin Tan, Sixue Chen, Ziye Qiu, Wenhao Li, Guozheng Jiang, Junji Yang, Xing Yu, Dingyan Zhao","doi":"10.1007/s00586-025-09027-0","DOIUrl":"https://doi.org/10.1007/s00586-025-09027-0","url":null,"abstract":"","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144316282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application value of Ultrasound-Guided cervical nerve root block test before percutaneous nucleoplasty in the treatment of patients with cervical chest pain: A retrospective study.","authors":"Limei Li, Xiaodong Liu, Tingting Liu, Yue Liu, Zhili Zhang","doi":"10.1007/s00586-025-08996-6","DOIUrl":"https://doi.org/10.1007/s00586-025-08996-6","url":null,"abstract":"<p><strong>Purpose: </strong>Cervical chest pain (CCP) is an atypical symptom of cervical spine disease that often overlaps with other chest-related diseases but a type of noncardiogenic chest pain. The obvious relief of CCP after selective cervical nerve root block (SCNRB) near intervertebral disc herniation under ultrasound guidance should be considered to help identify the potential pathological source.The purpose of this study was to explore the application value of a positive ultrasound-guided SCNRB test before percutaneous cervical nucleoplasty (PCN) in the treatment of patients with CCP.</p><p><strong>Methods: </strong>A retrospective analysis of 66 patients with CCP who underwent PCN was conducted. Patients were divided into a control group (PN group, n = 32) and an ultrasound-guided group (UPN group, n = 34) according to the absence or presence of ultrasound-guided SCNRB before surgery. The visual analogue scale (VAS) score, neck disability index (NDI), Pittsburgh Sleep Quality Index (PSQI), and proportion of patients taking oral analgesics before and at 1 week, 1 month, 3 months, and 6 months after surgery were recorded. The clinical effect according to the Odom criteria was recorded 6 months after surgery. The occurrence of adverse events was recorded to evaluate safety.</p><p><strong>Results: </strong>Compared with baseline, both groups showed significant improvement in VAS score, NDI, and PSQI at 1 week, 1 month, 3 months, and 6 months after surgery (P < 0.05). The proportion of patients taking oral analgesics sharply decreased at each time point after surgery. The VAS score, NDI, and PSQI at 1 week, 1 month, 3 months, and 6 months after surgery in the UPN group were lower than those in the PN group, and the Odom criteria rate of excellent and good performance in the UPN group was 91.2%, which was significantly greater than that in the PN group at 75.0% (P < 0.05).</p><p><strong>Conclusions: </strong>PCN can effectively alleviate the severity of chest pain, and improve sleep quality in patients with CCP. A positive ultrasound-guided SCNRB test before PCN can play a guiding role in identifying diseased nerves to improve the clinical efficacy of PCN in the treatment of CCP and can serve as a clinical reference.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Machine learning-based models for outcome prediction in skull base and spinal chordomas: a systematic review and meta-analysis.","authors":"Bardia Hajikarimloo, Ibrahim Mohammadzadeh, Azin Ebrahimi, Salem M Tos, Rana Hashemi, Arman Hasanzade, Mohammad Amin Habibi","doi":"10.1007/s00586-025-09053-y","DOIUrl":"https://doi.org/10.1007/s00586-025-09053-y","url":null,"abstract":"<p><strong>Background: </strong>Chordomas are primary bone lesions originating from embryonic notochord remnants, most commonly developing along the skull base and spine. Managing chordomas is challenging due to the complex surgical approaches and significant resistance to chemotherapy and radiation. Consequently, the prognosis for chordoma treatment is unfavorable. We aimed to systematically assess the outcomes of machine learning (ML) models in predicting progression, recurrence, and survival in chordoma patients.</p><p><strong>Methods: </strong>We conducted a systematic search on January 28, 2025, in PubMed, Embase, Scopus, and Web of Science. ML models that forecast skull base and spinal chordomas and report concordance index (C-index), area under the curve (AUC), accuracy (ACC), sensitivity, or specificity were included. A random-effects meta-analysis was performed using R with the \"meta\" and \"mada\" packages. The risk of bias (RoB) was assessed using the QUADAS-2 tool.</p><p><strong>Results: </strong>Fifteen studies involving 3525 chordomas were included. The meta-analysis exhibited a pooled C-index of 0.81 (0.79-0.83), an AUC of 0.86 (95% CI: 0.83-0.9), and an ACC of 0.8 (95% CI: 0.75-0.85). The meta-analysis showed a pooled sensitivity of 0.74 (95% CI: 0.71-0.77), a specificity of 0.78 (95% CI: 0.74-0.81), and a diagnostic odds ratio (DOR) of 12.1 (95% CI: 7.1-20.6).</p><p><strong>Conclusion: </strong>Our results indicated that ML models demonstrated robust predictive performance across various outcomes in chordomas, with pooled C-index, AUC, and ACC values ranging from 0.80 to 0.86 in relation to models that forecast progression, recurrence, or survival.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}