Respiratory dysfunction in degenerative cervical myelopathy: A systematic review

Area of Science:

• Neurology
• Pulmonology
• Spinal Cord Medicine

Background:

• Degenerative cervical myelopathy (DCM) involves spinal cord compression, often presenting with respiratory symptoms like shortness of breath.
• Previous studies suggest respiratory dysfunction in DCM patients, necessitating a systematic review of current evidence.

Approach:

• A systematic review adhering to PRISMA guidelines was conducted, searching Ovid MEDLINE and Embase.
• Included studies reported on respiratory function or disease in DCM patients.
• Risk of bias and GRADE assessments were performed, with a quantitative synthesis presented.

Key Points:

• Thirteen studies met inclusion criteria, analyzing various respiratory parameters.
• Forced vital capacity (FVC), peak expiratory flow rate (PEFR), and maximal voluntary ventilation (MVV) were generally lower in DCM patients compared to controls.
• Evidence regarding FEV1, surgical decompression effects, and compression level impact on respiratory function was inconsistent or conflicting.

Conclusions:

• DCM is potentially associated with respiratory dysfunction, but current evidence is limited in consistency and quality.
• Further research is required to rigorously characterize respiratory dysfunction in DCM.
• Investigating mechanisms like phrenic nerve disruption and brainstem pathway damage is crucial.