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Hereditary multiple exostoses is an autosomal dominant genetic disease characterized by multiple cartilage growth disorders, which affect the long bones of the limbs, scapula, and ribs, among others. Consensus on the diagnosis and treatment of spinal involvement is relatively lacking. For such patients, experience in terms of clinical screening, preoperative evaluation, surgical intervention indications and timing, surgical expertise and lessons learned, and follow-up is needed and critical. This review focuses on the clinical evaluation and orthopedic surgical treatment of HME patients with spinal involvement. It summarizes the patients\u2019 diagnosis, clinical features, and treatment strategies based on evidence from the published literature. The clinical manifestations, location of onset, and surgical intervention are summarized in detail in this review. The above contents will help improve the clinical diagnosis and treatment level of HME patients with spinal involvement internationally.<\/jats:p>","DOI":"10.1530\/eor-2025-0092","type":"journal-article","created":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T12:45:21Z","timestamp":1782909921000},"page":"837-848","update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-16","source":"Crossref","is-referenced-by-count":0,"title":["Orthopedic preoperative evaluation and surgical strategies of hereditary multiple osteochondromas involving the spinal region"],"prefix":"10.1530","volume":"11","author":[{"given":"Shuzhong","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China 1"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinyi","family":"Xing","sequence":"additional","affiliation":[{"name":"Department 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