# SpineBench: Benchmarking Multimodal LLMs for Spinal Pathology Analysis

arXiv: https://arxiv.org/abs/2510.12267 · HTML: https://mlsanity.com/paper/2510.12267/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Placed in Medical vision-language models, one of 16 directions in Multimodal LLMs / vision-language models.
- Builds on 19 of its 46 references that are in the map.
- First posted on arXiv 14 Oct 2025.

## Placed in

- Multimodal LLMs / vision-language models / [Medical vision-language models](https://mlsanity.com/mllm/medical-vision-language-models/)

## Builds on (most cited first, 19 of 19)

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- [LLaVA-Med: Training a Large Language-and-Vision Assistant for Biomedicine in One Day](https://mlsanity.com/paper/2306.00890/) (2023)
- [How Far Are We to GPT-4V? Closing the Gap to Commercial Multimodal Models with Open-Source Suites](https://mlsanity.com/paper/2404.16821/) (2024)
- [DeepSeek-VL2: Mixture-of-Experts Vision-Language Models for Advanced Multimodal Understanding](https://mlsanity.com/paper/2412.10302/) (2024)
- [PathVQA: 30000+ Questions for Medical Visual Question Answering](https://mlsanity.com/paper/2003.10286/) (2020)
- [SLAKE: A Semantically-Labeled Knowledge-Enhanced Dataset for Medical Visual Question Answering](https://mlsanity.com/paper/2102.09542/) (2021)
- [Med-Flamingo: a Multimodal Medical Few-shot Learner](https://mlsanity.com/paper/2307.15189/) (2023)
- [HuatuoGPT-Vision, Towards Injecting Medical Visual Knowledge into Multimodal LLMs at Scale](https://mlsanity.com/paper/2406.19280/) (2024)
- [Vision-Language Models for Medical Report Generation and Visual Question Answering: A Review](https://mlsanity.com/paper/2403.02469/) (2024)
- [HealthGPT: A Medical Large Vision-Language Model for Unifying Comprehension and Generation via Heterogeneous Knowledge Adaptation](https://mlsanity.com/paper/2502.09838/) (2025)
- [GMAI-MMBench: A Comprehensive Multimodal Evaluation Benchmark Towards General Medical AI](https://mlsanity.com/paper/2408.03361/) (2024)
- [Medical Image Understanding with Pretrained Vision Language Models: A Comprehensive Study](https://mlsanity.com/paper/2209.15517/) (2022)
- [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)
- [EyecareGPT: Boosting Comprehensive Ophthalmology Understanding with Tailored Dataset, Benchmark and Model](https://mlsanity.com/paper/2504.13650/) (2025)
- [VinDr-SpineXR: A deep learning framework for spinal lesions detection and classification from radiographs](https://mlsanity.com/paper/2106.12930/) (2021)
- [U2-BENCH: Benchmarking Large Vision-Language Models on Ultrasound Understanding](https://mlsanity.com/paper/2505.17779/) (2025)

## Abstract (arXiv)

With the increasing integration of Multimodal Large Language Models (MLLMs) into the medical field, comprehensive evaluation of their performance in various medical domains becomes critical. However, existing benchmarks primarily assess general medical tasks, inadequately capturing performance in nuanced areas like the spine, which relies heavily on visual input. To address this, we introduce SpineBench, a comprehensive Visual Question Answering (VQA) benchmark designed for fine-grained analysis and evaluation of MLLMs in the spinal domain. SpineBench comprises 64,878 QA pairs from 40,263 spine images, covering 11 spinal diseases through two critical clinical tasks: spinal disease diagnosis and spinal lesion localization, both in multiple-choice format. SpineBench is built by integrating and standardizing image-label pairs from open-source spinal disease datasets, and samples challenging hard negative options for each VQA pair based on visual similarity (similar but not the same disease), simulating real-world challenging scenarios. We evaluate 12 leading MLLMs on SpineBench. The results reveal that these models exhibit poor performance in spinal tasks, highlighting limitations of current MLLM in the spine domain and guiding future improvements in spinal medicine applications. SpineBench is publicly available at https://zhangchenghanyu.github.io/SpineBench.github.io/.