Rate of Spinal Osteochondromas Diagnosed in Pediatric Patients With Hereditary Multiple Osteochondromas
Bibliographic record
Abstract
BACKGROUND: Hereditary multiple osteochondromas (HMO) is a common pediatric condition defined by multiple cartilage-capped bony lesions. Spinal osteochondromas affect up to 68% of HMO patients. Although most are asymptomatic, intraspinal osteochondromas can cause significant neurological symptoms and morbidity. Limited guidelines exist regarding the use of advanced imaging to screen for spinal osteochondromas. This study evaluates the incidence of spinal osteochondromas detected through advanced imaging in pediatric HMO patients. METHODS: A systematic review and meta-analysis were conducted following the Cochrane Handbook for Systematic Reviews of Interventions. Included studies reported on the use of computed tomography (CT) or magnetic resonance imaging (MRI) in HMO patients under the age of 21. The primary outcome was spinal osteochondroma incidence. Secondary outcomes included imaging indication, symptoms, intraspinal lesion incidence, surgical intervention incidence, and postoperative outcomes. A meta-analysis of single proportions determined the pooled incidence of spinal osteochondromas, intraspinal lesions, and spinal surgery in HMO patients. RESULTS: Of 415 eligible articles, seven met inclusion criteria, including 198 HMO patients with a weighted mean age of 12 ± 1.0 years. MRI was the primary imaging modality in 175 patients (99%) with 136 (69%) imaged only per institutional screening protocols. Neurological symptoms were present in 41 subjects (21%) at the time of imaging. The pooled spinal osteochondroma incidence was 36% (95% CI, 24%-51%, event rate 72/183). Of these, 109 lesions (43%) were in the cervical spine, 41 lesions (38%) in the thoracic spine, and 21 lesions (19%) in the lumbar spine. Among those with spinal osteochondromas, 49% (95% CI, 37%-61%, event rate 41/85) had intraspinal lesions, and 21% (95% CI, 13%-33%, event rate 15/70) underwent surgery. Postoperatively, 17 patients (55%) experienced symptom resolution with no long-term complications reported. CONCLUSIONS: Although spinal osteochondromas are prevalent among HMO patients, standardized screening protocols remain limited. Nonetheless, initial and serial screening is needed to prevent irreversible neurological damage. As global guidelines evolve, large multicentre prospective studies are needed to identify and standardize optimal timing for spinal osteochondroma screening in HMO patients. LEVEL OF EVIDENCE: Level III.
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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 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| 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".