# SpineBench: A Clinically Salient, Level-Aware Benchmark Powered by the SpineMed-450k Corpus

arXiv: https://arxiv.org/abs/2510.03160 · HTML: https://mlsanity.com/paper/2510.03160/

## Key facts

- Cited by 1 papers in the map (data through 14 Oct 2026).
- Builds on 34 of its 66 references that are in the map.
- First posted on arXiv 3 Oct 2025.

## Builds on (most cited first, 30 of 34)

- [Qwen2.5-VL Technical Report](https://mlsanity.com/paper/2502.13923/) (2025)
- [GPT-4o System Card](https://mlsanity.com/paper/2410.21276/) (2024)
- [InternVL3.5: Advancing Open-Source Multimodal Models in Versatility, Reasoning, and Efficiency](https://mlsanity.com/paper/2508.18265/) (2025)
- [CheXpert: A Large Chest Radiograph Dataset with Uncertainty Labels and Expert Comparison](https://mlsanity.com/paper/1901.07031/) (2019)
- [LLaVA-Med: Training a Large Language-and-Vision Assistant for Biomedicine in One Day](https://mlsanity.com/paper/2306.00890/) (2023)
- [The Dawn of LMMs: Preliminary Explorations with GPT-4V(ision)](https://mlsanity.com/paper/2309.17421/) (2023)
- [MIMIC-CXR-JPG, a large publicly available database of labeled chest radiographs](https://mlsanity.com/paper/1901.07042/) (2019)
- [GLM-4.5V and GLM-4.1V-Thinking: Towards Versatile Multimodal Reasoning with Scalable Reinforcement Learning](https://mlsanity.com/paper/2507.01006/) (2025)
- [MedGemma Technical Report](https://mlsanity.com/paper/2507.05201/) (2025)
- [HuatuoGPT-o1, Towards Medical Complex Reasoning with LLMs](https://mlsanity.com/paper/2412.18925/) (2024)
- [Lingshu: A Generalist Foundation Model for Unified Multimodal Medical Understanding and Reasoning](https://mlsanity.com/paper/2506.07044/) (2025)
- [HuatuoGPT-Vision, Towards Injecting Medical Visual Knowledge into Multimodal LLMs at Scale](https://mlsanity.com/paper/2406.19280/) (2024)
- [PP-OCR: A Practical Ultra Lightweight OCR System](https://mlsanity.com/paper/2009.09941/) (2020)
- [Med-R1: Reinforcement Learning for Generalizable Medical Reasoning in Vision-Language Models](https://mlsanity.com/paper/2503.13939/) (2025)
- [HealthGPT: A Medical Large Vision-Language Model for Unifying Comprehension and Generation via Heterogeneous Knowledge Adaptation](https://mlsanity.com/paper/2502.09838/) (2025)
- [VerSe: A Vertebrae Labelling and Segmentation Benchmark for Multi-detector CT Images](https://mlsanity.com/paper/2001.09193/) (2020)
- [MedReason: Eliciting Factual Medical Reasoning Steps in LLMs via Knowledge Graphs](https://mlsanity.com/paper/2504.00993/) (2025)
- [Quilt-LLaVA: Visual Instruction Tuning by Extracting Localized Narratives from Open-Source Histopathology Videos](https://mlsanity.com/paper/2312.04746/) (2023)
- [MedTrinity-25M: A Large-scale Multimodal Dataset with Multigranular Annotations for Medicine](https://mlsanity.com/paper/2408.02900/) (2024)
- [MedAgent-Pro: Towards Evidence-based Multi-modal Medical Diagnosis via Reasoning Agentic Workflow](https://mlsanity.com/paper/2503.18968/) (2025)
- [MentaLLaMA: Interpretable Mental Health Analysis on Social Media with Large Language Models](https://mlsanity.com/paper/2309.13567/) (2023)
- [VILA-M3: Enhancing Vision-Language Models with Medical Expert Knowledge](https://mlsanity.com/paper/2411.12915/) (2024)
- [CBT-LLM: A Chinese Large Language Model for Cognitive Behavioral Therapy-based Mental Health Question Answering](https://mlsanity.com/paper/2403.16008/) (2024)
- [Less is More: Focus Attention for Efficient DETR](https://mlsanity.com/paper/2307.12612/) (2023)
- [Ivy-Fake: A Unified Explainable Framework and Benchmark for Image and Video AIGC Detection](https://mlsanity.com/paper/2506.00979/) (2025)
- [Lumbar spine segmentation in MR images: a dataset and a public benchmark](https://mlsanity.com/paper/2306.12217/) (2023)
- [A Computed Tomography Vertebral Segmentation Dataset with Anatomical Variations and Multi-Vendor Scanner Data](https://mlsanity.com/paper/2103.06360/) (2021)
- [VisionFM: a Multi-Modal Multi-Task Vision Foundation Model for Generalist Ophthalmic Artificial Intelligence](https://mlsanity.com/paper/2310.04992/) (2023)
- [Towards Better Dental AI: A Multimodal Benchmark and Instruction Dataset for Panoramic X-ray Analysis](https://mlsanity.com/paper/2509.09254/) (2025)
- [FiLA-Video: Spatio-Temporal Compression for Fine-Grained Long Video Understanding](https://mlsanity.com/paper/2504.20384/) (2025)

## Built on by (most cited first, 1 of 1)

- [TOBench: A Task-Oriented Omni-Modal Benchmark for Real-World Tool-Using Agents](https://mlsanity.com/paper/2605.16909/) (2026)

## Abstract (arXiv)

Spine disorders affect 619 million people globally and are a leading cause of disability, yet AI-assisted diagnosis remains limited by the lack of level-aware, multimodal datasets. Clinical decision-making for spine disorders requires sophisticated reasoning across X-ray, CT, and MRI at specific vertebral levels. However, progress has been constrained by the absence of traceable, clinically-grounded instruction data and standardized, spine-specific benchmarks. To address this, we introduce SpineMed, an ecosystem co-designed with practicing spine surgeons. It features SpineMed-450k, the first large-scale dataset explicitly designed for vertebral-level reasoning across imaging modalities with over 450,000 instruction instances, and SpineBench, a clinically-grounded evaluation framework. SpineMed-450k is curated from diverse sources, including textbooks, guidelines, open datasets, and ~1,000 de-identified hospital cases, using a clinician-in-the-loop pipeline with a two-stage LLM generation method (draft and revision) to ensure high-quality, traceable data for question-answering, multi-turn consultations, and report generation. SpineBench evaluates models on clinically salient axes, including level identification, pathology assessment, and surgical planning. Our comprehensive evaluation of several recently advanced large vision-language models (LVLMs) on SpineBench reveals systematic weaknesses in fine-grained, level-specific reasoning. In contrast, our model fine-tuned on SpineMed-450k demonstrates consistent and significant improvements across all tasks. Clinician assessments confirm the diagnostic clarity and practical utility of our model's outputs.