ReviewEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2026
Diagnostic errors in spinal metastases: a systematic review of contributing clinical and systemic factors.
Review 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. An erratum has been issued. Cited by 1 paper.
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
1 citing paper in PubMed.
- Teaching common cognitive biases and associated errors in veterinary neurologic diagnosis using clinical vignettes: a narrative review.Frontiers in veterinary science · 2026Review
Corrections and comments
- Erratum issued
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
STUDY
designSystematic review.
objectivesTo systematically review diagnostic errors in patients with spinal metastases, focusing on clinical, radiologic, and systemic factors contributing to missed or delayed diagnoses. This review addresses the clinical gap of delayed recognition, clarifies patterns of misdiagnosis, particularly in cases of spinal cord compression, and provides evidence to guide early detection and improve care pathways.
methodsWe conducted a comprehensive literature review of 51 peer-reviewed studies reporting diagnostic pathways and clinical outcomes in patients with spinal metastases. Articles were analyzed for documented reasons underlying misdiagnoses, including cognitive bias, missed red flags, imaging misuse or delay, absence of known cancer history, failure to order MRI, and lack of a documented differential diagnosis. Studies were categorized thematically and synthesized based on frequency and context of these contributing factors.
resultsMisdiagnosis of spinal metastases as mechanical back pain occurred frequently. Six studies explicitly reported misdiagnosis rates, with 40-70% of cases initially attributed to benign etiologies. Contributing factors included missed red flags (88.2% of studies), cognitive bias (64.7%), imaging misuse/delay (60.8%), lack of a known cancer history (19.6%), failure to order MRI (23.5%), and absence of a documented differential diagnosis (15.7%).
conclusionsMisdiagnosis of spinal metastases as mechanical back pain remains common, even in patients presenting with red-flag symptoms. Diagnostic delays are frequently due to cognitive heuristics, inappropriate imaging, or the absence of documented diagnostic reasoning. Early recognition and appropriate imaging are critical to prevent neurologic deterioration. Increased clinical awareness and diagnostic vigilance may improve outcomes for patients with metastatic spinal disease. By addressing the previously under-recognized clinical gap in early detection, this review highlights the need for heightened clinical awareness and systematic diagnostic vigilance to prevent neurologic deterioration.
Indexed as
Identifiers
41219480What Socratic 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 Socratic graph.