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Updated: Jun 19, 2026
Experimental Strategies to Bridge Large Tissue Gaps in the Injured Spinal Cord after Acute and Chronic Lesion
Published on: April 5, 2016
Preoperative Blood Spinal Cord Barrier Biomarker Levels Correlate with Neurological Outcome in Patients with
Tobias Philip Schmidt1, Kerstin Jütten1, Ulf Bertram1
1Department of Neurosurgery, RWTH Aachen University, Aachen, Germany.
Background:
Degenerative cervical myelopathy (DCM) is the leading cause of chronic spinal cord dysfunction and can lead to severe neurological impairment if untreated. While decompressive surgery is the standard treatment, predicting postoperative recovery remains a challenge. This study evaluates whether preoperative cerebrospinal fluid (CSF)/serum albumin and immunoglobulin (immunoglobulin G and immunoglobulin A) ratios, as indicators of blood-spinal cord barrier (BSCB) disruption, are associated biomarkers with long-term neurological recovery following surgery.
Methods:
We conducted a prospective, single-center cohort study involving 49 DCM patients (29 males, 20 females, mean age: 61 ± 17), with 38 completing a one-year follow-up. Preoperative BSCB integrity was assessed using Reiber diagnostics, which evaluates CSF/serum protein ratios. Neurological status was assessed using the modified Japanese Orthopaedic Association (mJOA) score.
Results:
Our results show a significant correlation between preoperative albumin, immunoglobulin G and immunoglobulin A CSF/serum ratios, and the one-year postoperative mJOA score (all P = 0.048). Lower ratios, predominantly accompanying a less severe BSCB disruption, were associated with better neurological outcomes (mJOA).
Conclusions:
These findings suggest that preoperative CSF/serum ratios have the potential to serve as biomarkers for postoperative recovery in DCM, supporting more personalized treatment planning. However, larger studies with more extensive cohorts are needed to validate these results and improve the statistical power of subgroup analyses. Future research should focus on refining BSCB-related diagnostics to enhance preoperative risk assessment.
