Spinal manifestations of Paget's disease: Case presentation and systematic review
Bibliographic record
Abstract
Introduction: Paget's disease of the bone (PDB) is a chronic disorder characterized by abnormal bone remodeling, often involving the spine. Although spinal stenosis and neural compression are well-documented manifestations, facet joint synovial cysts in PDB are extremely rare, and their development remains unclear. Research question: We report the case of a PDB patient who presented with progressive radicular symptoms due to an enlarged L1-L2 cyst with marked facet hypertrophy and stenosis. Materials and methods: We presented a case of a patient who underwent surgical decompression along with cyst excision, during which a thick-walled, hemorrhagic cyst compressing neural structures was identified. Postoperative neurological function exhibited enhancement. To compare with this case, we performed a systematic review adhering to PRISMA guidelines regarding spinal complications associated with PDB, encompassing ten articles and a cumulative total of 87 patients. Results: The most frequently reported manifestations included spinal stenosis, vertebral fracture, spinal cord compression, cauda equina syndrome, and neurological deficits. The literature only referred to one reported case of synovial cyst in relation to PDB. Discussions and conclusion: This article and case highlight that, while uncommon, facet joint synovial cysts belong in the correct differential diagnosis of the spinal manifestations of PDB, particularly when there is neural compression. Impeccable imaging and customized surgical planning are significant in the management of such complex cases.
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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 | 0.001 | 0.006 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.013 | 0.012 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 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 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".