Evidence map›Paper›PMID 40041396›Full record

ReviewBrain & spine2025

Cerebrospinal fluid pressure dynamics as a biomechanical marker for quantification of spinal cord compression: Conceptual framework and systematic review of clinical trials.

Najmeh Kheram, Madeleine A Bessen, Claire F Jones, Benjamin M Davies, Mark Kotter, Mazda Farshad, Markus Hupp, Daniel Nanz, Patrick Freund, Martin Schubert and 3 more

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Brain & spine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Najmeh KheramSpinal Cord Injury Center and Department of Neurology and Neurophysiology, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.
Madeleine A BessenAdelaide Medical School, The University of Adelaide, Adelaide, Australia.
Claire F JonesSchool of Electrical & Mechanical Engineering, The University of Adelaide, Adelaide, Australia.
Benjamin M DaviesDepartment of Neurosurgery, University of Cambridge, Cambridge, United Kingdom.
Mark KotterDepartment of Neurosurgery, University of Cambridge, Cambridge, United Kingdom.
Mazda FarshadUniversity Spine Center, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.
Markus HuppSpinal Cord Injury Center and Department of Neurology and Neurophysiology, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.
Daniel NanzSwiss Center for Musculoskeletal Imaging, Balgrist Campus AG, Zurich, Switzerland.
Patrick FreundSpinal Cord Injury Center and Department of Neurology and Neurophysiology, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.
Martin SchubertSpinal Cord Injury Center and Department of Neurology and Neurophysiology, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.
Vartan KurtcuogluThe Interface Group, Institute of Physiology, University of Zurich, Zurich, Switzerland.
Armin CurtSpinal Cord Injury Center and Department of Neurology and Neurophysiology, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.
Carl M ZipserSpinal Cord Injury Center and Department of Neurology and Neurophysiology, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction: In patients with acute spinal cord injury (SCI) and degenerative cervical myelopathy (DCM), spinal cord compression is considered a main contributor to spinal cord damage, associated with cerebrospinal fluid (CSF) space obstruction. CSF pressure (CSFP) dynamics are studied as a potential indirect biomechanical marker for spinal cord compression, and as a proxy to estimate spinal cord perfusion pressure (SCPP). Research question: Evidence for safety and feasibility of CSFP dynamics in clinical trials as well as interrelations with neuroimaging and intraspinal pressure, and relation to preclinical CSFP models. Material and methods: Systematic review. This review followed PRISMA guidelines, risk of bias assessment with ROBINS-I tool, PROSPERO registration (CRD42024545629). Results: 11 relevant papers were identified (n = 212 patients, n = 194 intraoperative, n = 18 bedside). Risk of bias for safety reporting was low-moderate. Intraoperative CSFP assessments were commonly performed in acute SCI. CSFP was assessed to calculate SCPP (7/11), to evaluate effects from surgical decompression (5/11) and for therapeutic CSF drainage (3/11). The adverse event rate associated with the intrathecal catheter was 8% (n = 15/194). Discussion and conclusion: The preliminary safety and feasibility profile of CSFP assessments in spinal cord compression encourages clinical application. However, a deeper risk-benefit analysis is limited as the clinical value is not yet determined, given challenges of defining disease specific critical CSFP and SCPP thresholds. The interrelation between measures of CSFP and neuroimaging is yet to be proven. Targeted preclinical studies are essential to improve our understanding of complex CSFP-cord compression interrelations.

Indexed as

Cerebrospinal fluid pressure dynamicsDegenerative cervical myelopathySpinal cord compressionSpinal cord injury

Identifiers

PMID40041396
PMCPMC11879606

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.