Descriptive analysis of primary intermediate and benign spine tumors: A retrospective study using the Bone and Soft Tissue Tumor Registry in Japan.
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BACKGROUND: Primary spine tumors are rare but can cause pain and neurological symptoms, occasionally requiring surgery. Previous national database studies have primarily focused on malignant spine tumors; however, data on primary intermediate spine tumors (PISTs) and primary benign spine tumors (PBSTs) remain limited. Therefore, we aimed to describe the demographic, clinical, and surgical characteristics of PISTs and PBSTs using the Bone and Soft Tissue Tumor (BSTT) Registry of the Japanese Orthopaedic Association. METHODS: We analyzed 908 cases of PISTs (n = 118) and PBSTs (n = 790) from the BSTT Registry (2006-2019). We evaluated and stratified the clinical, anatomical, and histological characteristics according to tumor grade, patient age, tumor location, and histological subtype. Surgical data were evaluated using procedure and margin status. RESULTS: Hemangiomas were the most common tumors (48.2 %), followed by giant cell tumor of bone (9.5 %) and Langerhans cell histiocytosis (7.0 %). PISTs were significantly more common in younger patients (p < 0.001), whereas PBSTs showed a bimodal age distribution. The lumbar spine was the most frequently affected site, with no significant difference between patients with PISTs and those with PBSTs (p = 0.521). Imaging-based diagnoses were frequent in patients with PBSTs (p < 0.001). Surgery was performed in 23.2 % of all cases and 63.6 % of patients with PISTs (p < 0.001). Resection was the most common procedure (63.5 %), and intralesional margins predominated (49.3 %), with margin status significantly differing according to tumor grade (p = 0.042). CONCLUSIONS: This nationwide registry study provides the largest dataset of PISTs and PBSTs to date, including 908 cases and 22 histological subtypes. Our findings highlight age- and location-specific tumor trends and offer valuable insights into real-world diagnostic and surgical practices. These results support future research and demonstrate the value of large-scale registry data for rare spinal tumors.