Bibliographic record
Abstract
Intradural spinal cord tumors are classified on the basis of their location in relation to the spinal cord parenchyma. Intramedullary spinal cord tumors (IMSCTs) exist within the spinal cord, while extramedullary spinal cord tumors (EMSCTs) exist outside the spinal cord within the subarachnoid space. Patients typically present with pain (local, radicular), sensory deficits (dysesthesias, numbness, proprioceptive loss), and/or weakness (focal weakness, clumsiness/falls). Diagnosis is typically based on imaging studies, including magnetic resonance imaging (MRI). The two most common types of IMSCTs are astrocytomas and ependymomas. Astrocytomas are diffuse, infiltrating lesions that heterogeneously enhance and can have intratumoral cysts and/or necrosis. Gross total resection is not possible because of the infiltrating nature of these lesions. Ependymomas, alternatively, are typically well circumscribed and may have rostral and/or caudal cysts. Adequate surgical treatment requires the surgeon to find a plane of resection to minimize the risk of recurrence. The two most common EMSCTs are nerve sheath tumors (schwannomas, neurofibromas) and meningiomas. Schwannomas do not involve the nerve root, so they typically can be resected without nerve root sacrifice, unlike neurofibromas, which involve and expand the nerve root. Meningiomas arise from the arachnoid cap cells, may have a dural tail, and can calcify. Imaging characteristics differ, in that nerve sheath tumors more typically show a heterogeneous enhancement pattern on MRI, and meningiomas homogeneously enhance. Both types of lesions widen the subarachnoid space and displace the spinal cord. Malignant transformation is rare. Treatment of these lesions is surgical. Neuromonitoring, consisting of somatosensory-evoked potentials, motor-evoked potentials, and epidural D-wave motor-evoked potentials, is used to guide the extent of surgical resection. Laminoplasty and laminectomy (with or without a fusion) are the most common surgical approaches. Complications include neurological deficits, Cerebrospinal fluid leak, wound infection, hematoma, and deep venous thrombosis /pulmonary embolism, as well as delayed postlaminectomy kyphosis in the absence of fusion. Radiation and/or chemotherapy may be required in patients with IMSCTs, or when EMSCTs demonstrate a more aggressive subtype. Patients are followed with serial MRI for recurrence. Overall, prognosis is dictated by the pathology and location of the individual tumor.
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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) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.013 | 0.008 |
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".