ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2026
Preoperative risk stratification for long-term neurological status in spinal ependymoma: an MRI-centered nomogram.
Article in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors.
Funding
Abstract
purposeDespite favorable long-term survival in WHO grade 2 spinal ependymoma, long-term neurological impairment remains clinically important. This study aimed to develop an MRI-centered preoperative nomogram for individualized prediction of long-term unfavorable neurological status.
methodsThis retrospective study included 582 patients with histopathologically confirmed WHO grade 2 spinal ependymoma. Long-term neurological status was assessed using the modified McCormick Scale (MMS), with final MMS > II defined as unfavorable status. Candidate preoperative predictors were evaluated using univariable logistic regression and collinearity diagnostics. The final model incorporated preoperative MMS and five routinely available MRI predictors: tumor-to-cord ratio, tumor location, intratumoral hemorrhage, peripheral edema, and MRI classification. Model performance was assessed using discrimination, calibration, bootstrap internal validation, and decision curve analysis.
resultsAmong 582 patients, 120 had unfavorable neurological status at final follow-up. The final MRI-centered model showed good discrimination, with an apparent AUC of 0.818 (95% CI, 0.776-0.859) and an optimism-corrected AUC of 0.797 after 1000 bootstrap resamples. Calibration analysis showed satisfactory agreement between predicted and observed probabilities, with a Brier score of 0.125. Decision curve analysis demonstrated positive net benefit over an approximate threshold range of 0.01-0.66.
conclusionAn MRI-centered preoperative nomogram integrating preoperative MMS and routinely available MRI predictors may support individualized risk stratification in patients with WHO grade 2 spinal ependymoma. This tool may assist preoperative counseling and risk-informed surgical planning, although external validation is required before broader clinical implementation.
Indexed as
Identifiers
42144464What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.