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Human spinal cord tissue is an underutilised resource in degenerative cervical myelopathy: findings from a systematic review of human autopsies

Human spinal cord tissue is an underutilised resource in degenerative cervical myelopathy: findings from a systematic review of human autopsies
Human spinal cord tissue is an underutilised resource in degenerative cervical myelopathy: findings from a systematic review of human autopsies
Study design: systematic review.

Background: although degenerative cervical myelopathy (DCM) is the most prevalent spinal cord condition worldwide, the pathophysiology remains poorly understood. Our objective was to evaluate existing histological findings of DCM on cadaveric human spinal cord tissue and explore their consistency with animal models.

Methods: MEDLINE and Embase were systematically searched (CRD42021281462) for primary research reporting on histological findings of DCM in human cadaveric spinal cord tissue. Data was extracted using a piloted proforma. Risk of bias was assessed using Joanna Briggs Institute critical appraisal tools. Findings were compared to a systematic review of animal models (Ahkter et al. 2020 Front Neurosci 14).

Results: the search yielded 4127 unique records. After abstract and full-text screening, 19 were included in the final analysis, reporting on 150 autopsies (71% male) with an average age at death of 67.3 years. All findings were based on haematoxylin and eosin (H&E) staining. The most commonly reported grey matter findings included neuronal loss and cavity formation. The most commonly reported white matter finding was demyelination. Axon loss, gliosis, necrosis and Schwann cell proliferation were also reported. Findings were consistent amongst cervical spondylotic myelopathy and ossification of the posterior longitudinal ligament. Cavitation was notably more prevalent in human autopsies compared to animal models.

Conclusion: few human spinal cord tissue studies have been performed. Neuronal loss, demyelination and cavitation were common findings. Investigating the biological basis of DCM is a critical research priority. Human spinal cord specimen may be an underutilised but complimentary approach.
0001-6268
1121-1131
Dohle, Esmee
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Beardall, Sophie
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Chang, Aina
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Mena, Karla P. Corral
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Jovanović, Luka
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Nath, Upamanyu
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Lee, Keng Siang
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Smith, Alexandria H.
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Thirunavukarasu, Arun J.
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Touzet, Alvaro Yanez
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Norton, Emma
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Mowforth, Oliver D.
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Kotter, Mark R.N.
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Davies, Benjamin M.
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Dohle, Esmee
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Beardall, Sophie
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Chang, Aina
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Mena, Karla P. Corral
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Jovanović, Luka
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Nath, Upamanyu
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Lee, Keng Siang
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Smith, Alexandria H.
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Thirunavukarasu, Arun J.
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Touzet, Alvaro Yanez
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Norton, Emma
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Mowforth, Oliver D.
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Kotter, Mark R.N.
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Davies, Benjamin M.
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Dohle, Esmee, Beardall, Sophie, Chang, Aina, Mena, Karla P. Corral, Jovanović, Luka, Nath, Upamanyu, Lee, Keng Siang, Smith, Alexandria H., Thirunavukarasu, Arun J., Touzet, Alvaro Yanez, Norton, Emma, Mowforth, Oliver D., Kotter, Mark R.N. and Davies, Benjamin M. (2023) Human spinal cord tissue is an underutilised resource in degenerative cervical myelopathy: findings from a systematic review of human autopsies. Acta Neurochirurgica, 165, 1121-1131. (doi:10.1007/s00701-023-05526-5).

Record type: Article

Abstract

Study design: systematic review.

Background: although degenerative cervical myelopathy (DCM) is the most prevalent spinal cord condition worldwide, the pathophysiology remains poorly understood. Our objective was to evaluate existing histological findings of DCM on cadaveric human spinal cord tissue and explore their consistency with animal models.

Methods: MEDLINE and Embase were systematically searched (CRD42021281462) for primary research reporting on histological findings of DCM in human cadaveric spinal cord tissue. Data was extracted using a piloted proforma. Risk of bias was assessed using Joanna Briggs Institute critical appraisal tools. Findings were compared to a systematic review of animal models (Ahkter et al. 2020 Front Neurosci 14).

Results: the search yielded 4127 unique records. After abstract and full-text screening, 19 were included in the final analysis, reporting on 150 autopsies (71% male) with an average age at death of 67.3 years. All findings were based on haematoxylin and eosin (H&E) staining. The most commonly reported grey matter findings included neuronal loss and cavity formation. The most commonly reported white matter finding was demyelination. Axon loss, gliosis, necrosis and Schwann cell proliferation were also reported. Findings were consistent amongst cervical spondylotic myelopathy and ossification of the posterior longitudinal ligament. Cavitation was notably more prevalent in human autopsies compared to animal models.

Conclusion: few human spinal cord tissue studies have been performed. Neuronal loss, demyelination and cavitation were common findings. Investigating the biological basis of DCM is a critical research priority. Human spinal cord specimen may be an underutilised but complimentary approach.

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Accepted/In Press date: 6 February 2023
Published date: 23 February 2023

Identifiers

Local EPrints ID: 499371
URI: http://eprints.soton.ac.uk/id/eprint/499371
ISSN: 0001-6268
PURE UUID: a22c9488-68d2-43d7-abf7-1c29ec21cc5f
ORCID for Emma Norton: ORCID iD orcid.org/0000-0003-1877-2474

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Date deposited: 18 Mar 2025 17:37
Last modified: 22 Aug 2025 02:44

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Contributors

Author: Esmee Dohle
Author: Sophie Beardall
Author: Aina Chang
Author: Karla P. Corral Mena
Author: Luka Jovanović
Author: Upamanyu Nath
Author: Keng Siang Lee
Author: Alexandria H. Smith
Author: Arun J. Thirunavukarasu
Author: Alvaro Yanez Touzet
Author: Emma Norton ORCID iD
Author: Oliver D. Mowforth
Author: Mark R.N. Kotter
Author: Benjamin M. Davies

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