PDF(Pubmed)
Abstract：
UNASSIGNED: Degenerative cervical myelopathy (DCM) is a form of chronic spinal cord injury, with a natural history of potential for progression over time. Whilst driven by mechanical stress on the spinal cord from degenerative and congenital pathology, the neurological phenotype of DCM is likely to be modified by multiple systemic factors. The role of metabolic factors is therefore of interest, particularly given that ischaemia is considered a key pathological mechanism of spinal cord injury. The objective was therefore to synthesise current evidence on the effect of metabolism on DCM susceptibility, severity, and surgical outcomes.
UNASSIGNED: A systematic review in MEDLINE and Embase was conducted following PRISMA guidelines. Full-text papers in English, with a focus on DCM and metabolism, including diabetes, cardiovascular disease, anaemia, and lipid profile, were eligible for inclusion. Risk of methodological bias was assessed using the Joanna Briggs Institute (JBI) critical assessment tools. Quality assessments were performed using the GRADE assessment tool. Patient demographics, metabolic factors and the relationships between metabolism and spinal cord disease, spinal column disease and post-operative outcomes were assessed.
UNASSIGNED: In total, 8,523 papers were identified, of which 57 met criteria for inclusion in the final analysis. A total of 91% (52/57) of included papers assessed the effects of diabetes in relation to DCM, of which 85% (44/52) reported an association with poor surgical outcomes; 42% of papers (24/57) discussed the association between cardiovascular health and DCM, of which 88% (21/24) reported a significant association. Overall, DCM patients with diabetes or cardiovascular disease experienced greater perioperative morbidity and poorer neurological recovery. They were also more likely to have comorbidities such as obesity and hyperlipidaemia.
UNASSIGNED: Metabolic factors appear to be associated with surgical outcomes in DCM. However, evidence for a more specific role in DCM susceptibility and severity is uncertain. The pathophysiology and natural history of DCM are critical research priorities; the role of metabolism is therefore a key area for future research focus.
UNASSIGNED: https://www.crd.york.ac.uk/prospero/, identifier: CRD42021268814.
UNASSIGNED: A systematic review in MEDLINE and Embase was conducted following PRISMA guidelines. Full-text papers in English, with a focus on DCM and metabolism, including diabetes, cardiovascular disease, anaemia, and lipid profile, were eligible for inclusion. Risk of methodological bias was assessed using the Joanna Briggs Institute (JBI) critical assessment tools. Quality assessments were performed using the GRADE assessment tool. Patient demographics, metabolic factors and the relationships between metabolism and spinal cord disease, spinal column disease and post-operative outcomes were assessed.
UNASSIGNED: In total, 8,523 papers were identified, of which 57 met criteria for inclusion in the final analysis. A total of 91% (52/57) of included papers assessed the effects of diabetes in relation to DCM, of which 85% (44/52) reported an association with poor surgical outcomes; 42% of papers (24/57) discussed the association between cardiovascular health and DCM, of which 88% (21/24) reported a significant association. Overall, DCM patients with diabetes or cardiovascular disease experienced greater perioperative morbidity and poorer neurological recovery. They were also more likely to have comorbidities such as obesity and hyperlipidaemia.
UNASSIGNED: Metabolic factors appear to be associated with surgical outcomes in DCM. However, evidence for a more specific role in DCM susceptibility and severity is uncertain. The pathophysiology and natural history of DCM are critical research priorities; the role of metabolism is therefore a key area for future research focus.
UNASSIGNED: https://www.crd.york.ac.uk/prospero/, identifier: CRD42021268814.
摘要：
■变性脊髓型颈椎病（DCM）是一种慢性脊髓损伤，具有随时间发展的自然史。虽然由退行性和先天性病理对脊髓的机械应力驱动，DCM的神经表型可能被多种系统因素改变。因此，代谢因子的作用是令人感兴趣的，特别是考虑到缺血被认为是脊髓损伤的关键病理机制。因此，我们的目标是综合目前关于代谢对DCM易感性的影响的证据，严重程度,和手术结果。
■根据PRISMA指南对MEDLINE和Embase进行了系统评价。英文全文论文,专注于DCM和新陈代谢，包括糖尿病,心血管疾病,贫血,和脂质分布，有资格列入。使用JoannaBriggs研究所（JBI）关键评估工具评估方法偏差的风险。使用GRADE评估工具进行质量评估。患者人口统计学，代谢因素以及代谢与脊髓疾病之间的关系，评估脊柱疾病和术后结局.
■总共，确定了8,523篇论文，其中57项符合纳入最终分析的标准。共有91%(52/57)的论文评估了糖尿病与DCM的关系。其中85%（44/52）报告与不良手术结果相关；42%（24/57）的论文讨论了心血管健康与DCM之间的关联，其中88%(21/24)报告存在显著关联。总的来说,患有糖尿病或心血管疾病的DCM患者的围手术期发病率更高，神经系统恢复较差。他们也更有可能患有肥胖和高脂血症等合并症。
■代谢因素似乎与DCM的手术结局相关。然而,在DCM易感性和严重程度中更具体作用的证据尚不确定。DCM的病理生理学和自然史是关键的研究重点；因此，代谢的作用是未来研究重点的关键领域。
■https://www.crd.约克。AC.英国/普华永道/，标识符：CRD42021268814。
■根据PRISMA指南对MEDLINE和Embase进行了系统评价。英文全文论文,专注于DCM和新陈代谢，包括糖尿病,心血管疾病,贫血,和脂质分布，有资格列入。使用JoannaBriggs研究所（JBI）关键评估工具评估方法偏差的风险。使用GRADE评估工具进行质量评估。患者人口统计学，代谢因素以及代谢与脊髓疾病之间的关系，评估脊柱疾病和术后结局.
■总共，确定了8,523篇论文，其中57项符合纳入最终分析的标准。共有91%(52/57)的论文评估了糖尿病与DCM的关系。其中85%（44/52）报告与不良手术结果相关；42%（24/57）的论文讨论了心血管健康与DCM之间的关联，其中88%(21/24)报告存在显著关联。总的来说,患有糖尿病或心血管疾病的DCM患者的围手术期发病率更高，神经系统恢复较差。他们也更有可能患有肥胖和高脂血症等合并症。
■代谢因素似乎与DCM的手术结局相关。然而,在DCM易感性和严重程度中更具体作用的证据尚不确定。DCM的病理生理学和自然史是关键的研究重点；因此，代谢的作用是未来研究重点的关键领域。
■https://www.crd.约克。AC.英国/普华永道/，标识符：CRD42021268814。
