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
Benign notochordal cell tumours of the spine: imaging characteristics and longitudinal imaging follow-up.
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.
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Abstract
backgroundBenign notochordal cell tumours (BNCTs) are non-aggressive intraosseous lesions arising from notochordal remnants within the axial skeleton. This study aimed to evaluate their computed tomography (CT) and magnetic resonance imaging (MRI) features and to define how serial imaging follow-up can be used to monitor these lesions.
methodsA retrospective review with institutional ethical approval included all patients diagnosed with spinal BNCTs at a tertiary orthopaedic oncology centre between June 2008 and October 2025. Imaging studies were reviewed by consensus of three fellowship-trained musculoskeletal radiologists. Lesions were assessed using CT and MRI for location, size, margins, presence of concerning features, and interval change on follow-up imaging.
resultsNineteen patients were included (11 females, 8 males; mean age 44.6 years, range 16-66 years). All BNCTs were incidentally discovered, solitary, well-defined, intraosseous lesions located in the midline of the vertebral bodies, without cortical destruction or extraosseous components. Most were sacral (14/19, 73.7%). Mean maximal lesion size was 1.7 cm. On MRI, 18/19 lesions demonstrated homogeneous low-to-intermediate T1-weighted and high T2-weighted/STIR signal intensity. Internal microscopic fat was present in 9/12 cases. On CT, lesions typically presented with faint sclerosis (10/12). Four lesions with atypical imaging features underwent biopsy and were confirmed as BNCTs. Mean imaging follow-up was 34.2 months (range 1 month to 11 years). All lesions remained stable throughout follow-up.
conclusionsIncidental spinal BNCTs demonstrate characteristic non-aggressive CT and MRI features and stability on longitudinal imaging follow-up. Lesions without concerning imaging features can be appropriately managed with interval imaging surveillance.
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