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Review
. 2021 Oct 30:14:11786388211054664.
doi: 10.1177/11786388211054664. eCollection 2021.

The Role of Nutrition in Degenerative Cervical Myelopathy: A Systematic Review

Celine I Partha Sarathi  1 , Oliver D Mowforth  1 , Amil Sinha  1 , Faheem Bhatti  1 , Aniqah Bhatti  1 , Melika Akhbari  1 , Shahzaib Ahmed  1 , Benjamin M Davies  1
Affiliations
Review

The Role of Nutrition in Degenerative Cervical Myelopathy: A Systematic Review

Celine I Partha Sarathi et al. Nutr Metab Insights. .

Abstract

Introduction: Degenerative cervical myelopathy (DCM) is the commonest cause of adult spinal cord impairment worldwide, encompassing chronic compression of the spinal cord, neurological disability and diminished quality of life. Evidence on the contribution of environmental factors is sparse; in particular, the role of nutrition in DCM is unknown. The objective of this review was to assess the effect of nutrition on DCM susceptibility, severity and surgical outcome.

Methods: A systematic review in MEDLINE and Embase was conducted following PRISMA guidelines. Full-text papers in English papers, focussing on cervical myelopathy and nutrition, published before January 2020 were considered eligible. Quality assessments were performed using the GRADE assessment tool. Patient demographics, nutritional factor and DCM outcomes measures were recorded. Relationships between nutritional factors, interventions and disease prognosis were assessed.

Results: In total, 5835 papers were identified of which 44 were included in the final analysis. DCM patients with pathological weight pre-operatively were more likely to see poorer improvements post-surgically. These patients experienced poorer physical and mental health improvements from surgery compared to normal weight patients and were more likely to suffer from post-operative complications such as infection, DVT, PE and hospital readmissions. Two trials reporting benefits of nutritional supplements were identified, with 1 suggesting Cerebrolysin to be significant in functional improvement. An unbalanced diet, history of alcohol abuse and malnourishment were associated with poorer post-operative outcome.

Conclusion: Although the overall strength of recommendation is low, current evidence suggests nutrition may have a significant role in optimising surgical outcome in DCM patients. Although it may have a role in onset and severity of DCM, this is a preliminary suggestion. Further work needs to be done on how nutrition is defined and measured, however, the beneficial results from studies with nutritional interventions suggest nutrition could be a treatment target in DCM.

Keywords: Cervical cord; body weight; degeneration; electrolytes; gastrointestinal diseases; hospitalisation; malnutrition; minerals; myelopathy; nutritional status; obesity; ossification posterior longitudinal ligament; spondylosis; stenosis; vitamins.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship and/or publication of this article: This report is independent research arising from a Clinician Scientist Award, CS-2015-15-023, supported by the National Institute for Health Research. The views expressed in this publication are those of the authors and not necessarily those of the NHS, the National Institute for Health Research or the Department of Health and Social Care.

Figures

Figure 1.
Figure 1.
PRISMA flow diagram.
See this image and copyright information in PMC

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