The younger age at diagnosis aligns with findings from previous studies.4,10,25 Furthermore, the higher prevalence of VHL-associated sHBs in lower spinal levels was also found in the retrospective investigation of 35 patients by Takai et al.25 A novel finding is the higher prevalence of intramedullary tumor component among those with a VHL-associated sHB. This evidence concerns the gene VHL and neoplasm.