The Mechanical Properties of the Spinal Cord: A Protocol for a Systematic Review

Abstract

Abstract Background Spinal cord compression is a source of pathology seen in routine clinical practice. However, there remains a number of unanswered questions around both the understanding of the pathogenesis and the best method of treatment of the condition. This is partly due to the issues of the real life testing around the physical properties of the spinal cord, either through the use of cadaveric human specimens or thought animal testing, both of which have methodological, as well as ethical, issues. Methods This paper details a protocol for a systematic review of the literature of all the previous descriptions of physical models of the spinal cord. We will conduct a literature search of a number of electronic databases, along with the grey literature, as a single stage search. All literature will be screened for appropriate studies which will then be reviewed fully to extract relevant information on the methodology and mechanics of the reported testing along with the results. Two reviewers will separately screen the citations and abstract the data, with comparison of results to ensure concordance. Conflicts, will be resolved through discussion and arbitration via an independent arbitrator. The methodological quality of the studies will be assessed within the ARRIVE guidelines using the CAMARADES framework and SYRCLE risk of bias tool. A narrative synthesis will be created with the appropriate tables to describe the demographics and findings of the included studies. Discussion The future systematic review will form the basis of a full understanding of the current literature around the physical properties of the spinal cord. This will allow future work to develop a physical model of the spinal cord, which is applicable to the living human, for analysis and testing in a controlled and repeatable fashion. Such a model would be the basis for further clinical research to improve outcomes from this condition. Systematic review registration: Prospero registration number: CRD42022361933