{
  "abstract": "Background/Objectives: Neurologic presentation varies among patients with high-grade metastatic epidural spinal cord compression (MESCC), even within Bilsky grades 2-3. We examined whether quantitative preservation of spinal cord caliber is associated with neurologic intactness at presentation. Methods: We retrospectively studied 73 adults who underwent surgery for thoracic Bilsky grade 2-3 MESCC between June 2020 and December 2025. Preoperative neurologic status was classified as Frankel E versus Frankel A-D. Blinded observers measured anteroposterior and transverse cord diameters at maximal compression and at the first tumor-free cranial and caudal pedicle levels. A normalized two-adjacent cord compression ratio (CCR) was available in 71 patients. Modified Poisson regression estimated prevalence ratios for Frankel-E status, adjusted for Bilsky grade; logistic, Firth, and cranial-reference analyses were used as sensitivity analyses. Results: Twenty-two patients (30.1%) were Frankel E. Two-adjacent CCR was higher in Frankel-E than Frankel A-D patients (median 0.521 vs. 0.439; p = 0.013). Each 0.10 increase in CCR was associated with greater prevalence of Frankel-E status after Bilsky adjustment (PR 1.23, 95% CI 1.04-1.47; p = 0.018). Logistic, Firth, and cranial-reference analyses were generally consistent in direction; the solid-tumor-only estimate also remained positive but was less precise and included the null. Interobserver agreement for CCR was acceptable but imprecise (ICC[A,1] = 0.758, 95% CI 0.433-0.911). Conclusions: In this surgically selected cohort, normalized cord-caliber preservation was associated with neurologic intactness after accounting for Bilsky grade. CCR should be regarded as a research phenotype rather than an individual-patient predictor or treatment threshold, pending prospective validation in broader surgical and nonsurgical populations.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Neurosurgery, Basaksehir Cam and Sakura City Hospital, 34480 Istanbul, Türkiye."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 4,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Ilhan Yilmaz"
    },
    {
      "affs": [
        0
      ],
      "name": "Baran Taskala",
      "orcid": "0000-0002-3398-3846"
    },
    {
      "affs": [
        0
      ],
      "name": "Muhammed Bayindir",
      "orcid": "0009-0001-2411-0672"
    },
    {
      "affs": [
        0
      ],
      "name": "Aydin Talat Baydar",
      "orcid": "0000-0002-9552-8179"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/cem2hma7nsnz2.bib",
  "cited_by": 0,
  "doi": "10.3390/jcm15197702",
  "fulltext_url": "https://europepmc.org/articles/PMC13665715",
  "id": "cem2hma7nsnz2",
  "issns": [
    "2077-0383"
  ],
  "landing_url": "https://europepmc.org/article/MED/42882163",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2746|Management of metastatic bone disease"
    ]
  ],
  "openalex": "W7220372407",
  "pdf_url": "https://europepmc.org/articles/PMC13665715?pdf=render",
  "pmcid": "PMC13665715",
  "pmid": "42882163",
  "published": "2026-10-05",
  "publisher": "MDPI AG",
  "ris": "https://research.draconitic.com/paper/cem2hma7nsnz2.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:00Z",
      "native_id": "MED:42882163",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42882163"
    },
    {
      "first_seen": "2026-10-30T12:20:00Z",
      "native_id": "10.3390/jcm15197702",
      "source": "crossref",
      "url": "https://www.mdpi.com/2077-0383/15/19/7702"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2746|Management of metastatic bone disease",
      "subfield": "surgery"
    }
  ],
  "title": "Quantitative Spinal Cord Deformation Is Associated with Neurologic Status in High-Grade Thoracic Metastatic Epidural Spinal Cord Compression: A Retrospective Surgical Cohort.",
  "title_text": "Quantitative Spinal Cord Deformation Is Associated with Neurologic Status in High-Grade Thoracic Metastatic Epidural Spinal Cord Compression: A Retrospective Surgical Cohort.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:20:00Z",
  "url": "https://research.draconitic.com/paper/cem2hma7nsnz2",
  "venue": "Journal of clinical medicine",
  "versions": []
}