Abstract：
BACKGROUND: Degenerative cervical myelopathy is a condition of symptomatic cervical spinal cord compression secondary to a range of degenerative spinal pathology. Respiratory symptoms such as shortness of breath are not uncommonly reported by people with DCM and respiratory dysfunction has been described in several DCM studies. The objective of this review was therefore to systematically synthesise the current evidence on the relationship between DCM and respiratory function.
METHODS: The review was registered on PROSPERO and adhered to PRISMA guidelines. Ovid MEDLINE and Embase were searched from inception to 14th March 2023. DCM studies reporting on any measure or outcome relating to respiratory function or disease were eligible. Reference lists of included studies and relevant reviews articles were hand searched. Title, abstract and full text screening, risk of bias and GRADE assessments were completed in duplicate. A quantitative synthesis is presented.
RESULTS: Of 1991 studies identified by literature searching, 13 met inclusion criteria: 3 cohort studies, 5 case-control studies, 1 case series and 4 case studies. Forced vital capacity (FVC), peak expiratory flow rate (PEFR) and maximal voluntary ventilation (MVV) were reported to be lower in DCM patients than controls; there was inconsistency in comparisons of forced expiratory volume in 1 s (FEV1). There was conflicting evidence on whether surgical decompression was associated with improvements in respiratory parameters and on the relationship between level of spinal cord compression and respiratory dysfunction.
CONCLUSIONS: DCM may be associated with respiratory dysfunction. However, consistency and quality of evidence is currently low. Further work should characterise respiratory dysfunction in DCM patients more rigorously and investigate putative mechanisms such as disruption to cervical nerve roots responsible for diaphragmatic innervation and damage to descending spinal projections from brainstem respiratory centres.
METHODS: The review was registered on PROSPERO and adhered to PRISMA guidelines. Ovid MEDLINE and Embase were searched from inception to 14th March 2023. DCM studies reporting on any measure or outcome relating to respiratory function or disease were eligible. Reference lists of included studies and relevant reviews articles were hand searched. Title, abstract and full text screening, risk of bias and GRADE assessments were completed in duplicate. A quantitative synthesis is presented.
RESULTS: Of 1991 studies identified by literature searching, 13 met inclusion criteria: 3 cohort studies, 5 case-control studies, 1 case series and 4 case studies. Forced vital capacity (FVC), peak expiratory flow rate (PEFR) and maximal voluntary ventilation (MVV) were reported to be lower in DCM patients than controls; there was inconsistency in comparisons of forced expiratory volume in 1 s (FEV1). There was conflicting evidence on whether surgical decompression was associated with improvements in respiratory parameters and on the relationship between level of spinal cord compression and respiratory dysfunction.
CONCLUSIONS: DCM may be associated with respiratory dysfunction. However, consistency and quality of evidence is currently low. Further work should characterise respiratory dysfunction in DCM patients more rigorously and investigate putative mechanisms such as disruption to cervical nerve roots responsible for diaphragmatic innervation and damage to descending spinal projections from brainstem respiratory centres.
摘要：
背景：退行性脊髓型颈椎病是一系列退行性脊柱病理继发的症状性颈脊髓压迫。患有DCM的人并不罕见地报告呼吸症状，例如呼吸急促，并且在几项DCM研究中已经描述了呼吸功能障碍。因此，本综述的目的是系统地综合有关DCM与呼吸功能之间关系的当前证据。
方法：该综述在PROSPERO上注册，并遵守PRISMA指南。OvidMEDLINE和Embase从成立到2023年3月14日进行了搜索。报告与呼吸功能或疾病有关的任何测量或结果的DCM研究均合格。手工检索了纳入研究的参考列表和相关评论文章。Title,摘要和全文筛选，偏差风险和等级评估一式两份完成.提出了定量合成。
结果：在1991年通过文献检索确定的研究中，13项符合纳入标准：3项队列研究，5个病例对照研究，1个案例系列和4个案例研究。强迫肺活量（FVC），据报道，DCM患者的最大呼气流量（PEFR）和最大自主通气（MVV）低于对照组；1s内用力呼气量（FEV1）的比较存在不一致。关于手术减压是否与呼吸参数的改善以及脊髓压迫水平与呼吸功能障碍之间的关系，存在矛盾的证据。
结论：DCM可能与呼吸功能障碍有关。然而,目前证据的一致性和质量较低。进一步的工作应更严格地描述DCM患者的呼吸功能障碍，并研究假定的机制，例如对引起diaphragm肌神经支配的颈神经根的破坏以及对来自脑干呼吸中心的下行脊柱投射的损害。
方法：该综述在PROSPERO上注册，并遵守PRISMA指南。OvidMEDLINE和Embase从成立到2023年3月14日进行了搜索。报告与呼吸功能或疾病有关的任何测量或结果的DCM研究均合格。手工检索了纳入研究的参考列表和相关评论文章。Title,摘要和全文筛选，偏差风险和等级评估一式两份完成.提出了定量合成。
结果：在1991年通过文献检索确定的研究中，13项符合纳入标准：3项队列研究，5个病例对照研究，1个案例系列和4个案例研究。强迫肺活量（FVC），据报道，DCM患者的最大呼气流量（PEFR）和最大自主通气（MVV）低于对照组；1s内用力呼气量（FEV1）的比较存在不一致。关于手术减压是否与呼吸参数的改善以及脊髓压迫水平与呼吸功能障碍之间的关系，存在矛盾的证据。
结论：DCM可能与呼吸功能障碍有关。然而,目前证据的一致性和质量较低。进一步的工作应更严格地描述DCM患者的呼吸功能障碍，并研究假定的机制，例如对引起diaphragm肌神经支配的颈神经根的破坏以及对来自脑干呼吸中心的下行脊柱投射的损害。
