Objectives Whilst radiological evidence of compression is the hallmark of degenerative cervical myelopathy [DCM], it is unable to stage or prognosticate. Moreover, asymptomatic spinal cord compression is common and therefore new methods of assessing spinal cord function are required. We aimed to: 1) Evaluate the evidence-base for serum and CSF biomarkers of spinal cord damage in diagnosis, prognosis or predicting response to treatment in DCM 2) Identify serum and CSF biomarkers of spinal cord damage studied in other conditions, which may have relevance to DCM.
Design Scoping review.
Subjects Human only.
Methods A search of MEDLINE and EMBASE was performed. Studies involving DCM patients or biomarkers relevant to spinal cord pathobiology were included.
Results 852 results were screened, of which 83 were included. 9 studies explored 12 biomarkers in DCM. NFH (n=3), S100b and NSE (n=2) received most study. 74 studies explored a further 118 biomarkers in other conditions; S100b (n=13), NFH (n=11) and GFAP (n=10) received most study. Overall, 72 studies used targeted approaches, in which candidate biomarkers were chosen in advance. 11 used unbiased approaches, in which high throughput analyses identified candidate biomarkers during the study.
Conclusions The evidence-base for use of biomarkers in DCM is limited. Whilst targeted approaches have identified a number of candidate spinal cord markers, few have shown clinical utility. There is a shift towards investigating panels of multiple markers and unbiased, high-throughput approaches.
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