Kann Michael R, Lavadi Raj Swaroop, Crane Alex, Aizooky Taim, Hardi Angela, Polavarapu Hanish, Kumar Rohit Prem, Mitha Rida, Shah Manan, Hamilton D Kojo, Agarwal Nitin
Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Becker Medical Library, Washington University School of Medicine, St. Louis, MO, USA.
Neurosurg Rev. 2025 Feb 13;48(1):232. doi: 10.1007/s10143-025-03217-6.
There is a scarcity of literature exploring fluid-based biomarkers that have the potential to provide deeper insights into the cellular mechanisms underlying cervical spondylotic myelopathy (CSM) symptom presentation and postoperative recovery. This systematic review synthesized the literature on invasive, fluid-based biomarkers and their clinical significance with CSM.
A comprehensive search strategy was developed for concepts of biomarkers and CSM. Retrieved results underwent title, abstract, and full-text screening with inclusion criteria being original research including animal or human subjects affected by CSM/compression myelopathy that investigated the relationship between a fluid-based biomarker and CSM. Risk-of-bias was reported using the OHAT Risk of Bias Rating Tool.
The search strategy resulted in 191 unique manuscripts, with 20 meeting the predetermined inclusion/exclusion criteria, included in final analysis. Of these, 15 (75.0%) were human studies, two (10.0%) were animal studies, and three studies (15.0%) included both human and animal subjects. Across human studies, the fluid utilized for biomarker assessment was blood, (N = 8, 44.4%), cerebrospinal fluid (CSF) (N = 9, 50.0%), and both blood and CSF (N = 1, 5.6%). The three most common biomarkers assessed across human studies were NSE (N = 4, 22.2%), S100b (N = 4, 22.2%), and pNF-H (N = 4, 22.2%). Risk of bias due to inadequate comparison groups was present in three human studies (16.7%) and two animal studies (40%).
This comprehensive systematic review identified several associations between blood and CSF-based neural, glial, and inflammatory biomarkers and CSM. However, the vast heterogeneity across studies renders it difficult to draw definitive conclusions. Future research within larger, prospective patient cohorts is needed to fully elucidate the utility these biomarkers may hold in the clinical evaluation of patients with CSM.
探索基于体液的生物标志物的文献稀缺，这些生物标志物有可能更深入地洞察脊髓型颈椎病（CSM）症状表现和术后恢复的细胞机制。本系统评价综合了关于侵入性、基于体液的生物标志物及其与CSM临床意义的文献。
针对生物标志物和CSM的概念制定了全面的检索策略。检索结果经过标题、摘要和全文筛选，纳入标准为包括受CSM/压迫性脊髓病影响的动物或人类受试者的原始研究，该研究调查了基于体液的生物标志物与CSM之间的关系。使用OHAT偏倚风险评级工具报告偏倚风险。
检索策略产生了191篇独特的手稿，其中20篇符合预定的纳入/排除标准，纳入最终分析。其中，15篇（75.0%）是人体研究，2篇（10.0%）是动物研究，3篇研究（15.0%）包括人体和动物受试者。在人体研究中，用于生物标志物评估的体液是血液（N = 8，44.4%）、脑脊液（CSF）（N = 9，50.0%）以及血液和脑脊液（N = 1，5.6%）。在人体研究中评估的三种最常见的生物标志物是神经元特异性烯醇化酶（NSE）（N = 4，22.2%）、S100β蛋白（S100b）（N = 4，22.2%）和磷酸化神经丝重链（pNF-H）（N = 4，22.2%）。三项人体研究（16.7%）和两项动物研究（40%）存在因对照组不足导致的偏倚风险。
这项全面的系统评价确定了血液和脑脊液中基于神经、胶质和炎症的生物标志物与CSM之间的几种关联。然而，研究之间存在巨大的异质性，难以得出明确的结论。需要在更大规模的前瞻性患者队列中进行未来研究，以充分阐明这些生物标志物在CSM患者临床评估中的效用。
