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

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dc.contributor.authorPartha Sarathi, Celine I
dc.contributor.authorMowforth, Oliver D
dc.contributor.authorSinha, Amil
dc.contributor.authorBhatti, Faheem
dc.contributor.authorBhatti, Aniqah
dc.contributor.authorAkhbari, Melika
dc.contributor.authorAhmed, Shahzaib
dc.contributor.authorDavies, Benjamin M
dc.contributor.orcidPartha Sarathi, Celine I [0000-0001-5314-5762]
dc.contributor.orcidSinha, Amil [0000-0002-3092-498X]
dc.contributor.orcidBhatti, Faheem [0000-0003-3897-4196]
dc.date.accessioned2021-10-31T15:21:21Z
dc.date.available2021-10-31T15:21:21Z
dc.date.issued2021-10-30
dc.date.submitted2021-06-20
dc.date.updated2021-10-31T15:21:20Z
dc.description.abstractIntroduction:: 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.
dc.identifier.doi10.17863/CAM.77565
dc.identifier.eissn1178-6388
dc.identifier.other10.1177_11786388211054664
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/330120
dc.languageen
dc.publisherSAGE Publications
dc.rightsEmbargo: ends 2021-10-30
dc.subjectReview
dc.subjectCervical cord
dc.subjectmyelopathy
dc.subjectspondylosis
dc.subjectstenosis
dc.subjectossification posterior longitudinal ligament
dc.subjectdegeneration
dc.subjectnutritional status
dc.subjectmalnutrition
dc.subjectvitamins
dc.subjectminerals
dc.subjectobesity
dc.subjectbody weight
dc.subjectgastrointestinal diseases
dc.subjectelectrolytes
dc.subjecthospitalisation
dc.titleThe Role of Nutrition in Degenerative Cervical Myelopathy: A Systematic Review
dc.typeArticle
dcterms.dateAccepted2021-10-03
prism.publicationNameNutrition and Metabolic Insights
prism.volume14
rioxxterms.licenseref.startdate2021-10-30
rioxxterms.licenseref.urihttps://creativecommons.org/licenses/by/4.0/
rioxxterms.versionVoR
rioxxterms.versionofrecord10.1177/11786388211054664

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