The impact of spinal cord nerve roots and denticulate ligaments on cerebrospinal fluid dynamics in the cervical spine.
The impact of spinal cord nerve roots and denticulate ligaments on cerebrospinal fluid dynamics in the cervical spine.
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DOI：
10.1371/journal.pone.0091888
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发表时间：
2014
期刊：
影响因子：
3.7
通讯作者：
Martin BA
中科院分区：
文献类型：
--
作者：
Heidari Pahlavian S;Yiallourou T;Tubbs RS;Bunck AC;Loth F;Goodin M;Raisee M;Martin BA
脊髓蛛网膜下腔(SSS)中的脑脊液(CSF)动力学被认为在脊髓空洞症、Chiari I畸形(CM)以及鞘内给药中起着重要的病理生理作用。然而，包括神经根和齿状韧带(NRDL)在内的精细解剖结构对SSS脑脊液动力学的影响尚不清楚。在本研究中，我们评估了NRDL对颈椎SSS患者脑脊液动力学的影响。基于手动分割一名健康志愿者和一名CM患者的MRI图像，重建了颈椎SSS的3D几何形状。根据文献中的活体测量和神经解剖学家的确认，理想的NRDL被设计并添加到每个几何图形中。CFD模拟是对健康和患者的病例进行的，包括NRDL和不包括NRDL。结果表明，NRDL在速度场和流型方面对脑脊液动力学有重要影响。然而，压力分布没有太大的变化，尽管NRDL情况下需要更大的压力梯度来保持相同的流量。此外，对于健康受试者和轻度扁桃体突出症(∼为6 mm)的CM患者，NRDL术也不会在很大程度上改变从枕大孔到C1水平的SSs的脑脊液动力学。总体而言，NRDL增加了流体混合现象，导致了更复杂的流场。流线的比较表明，NRDL的存在导致了涡旋结构的形成，并显著地增加了整个SSS中CSFs的局部混合。
Cerebrospinal fluid (CSF) dynamics in the spinal subarachnoid space (SSS) have been thought to play an important pathophysiological role in syringomyelia, Chiari I malformation (CM), and a role in intrathecal drug delivery. Yet, the impact that fine anatomical structures, including nerve roots and denticulate ligaments (NRDL), have on SSS CSF dynamics is not clear. In the present study we assessed the impact of NRDL on CSF dynamics in the cervical SSS. The 3D geometry of the cervical SSS was reconstructed based on manual segmentation of MRI images of a healthy volunteer and a patient with CM. Idealized NRDL were designed and added to each of the geometries based on in vivo measurments in the literature and confirmation by a neuroanatomist. CFD simulations were performed for the healthy and patient case with and without NRDL included. Our results showed that the NRDL had an important impact on CSF dynamics in terms of velocity field and flow patterns. However, pressure distribution was not altered greatly although the NRDL cases required a larger pressure gradient to maintain the same flow. Also, the NRDL did not alter CSF dynamics to a great degree in the SSS from the foramen magnum to the C1 level for the healthy subject and CM patient with mild tonsillar herniation (∼6 mm). Overall, the NRDL increased fluid mixing phenomena and resulted in a more complex flow field. Comparison of the streamlines of CSF flow revealed that the presence of NRDL lead to the formation of vortical structures and remarkably increased the local mixing of the CSF throughout the SSS.
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影响因子：
2.4
作者：
Cheng, Shaokoon;Stoodley, Marcus A.;Bilston, Lynne E.
通讯作者：
Bilston, Lynne E.
影响因子：
4.1
作者：
Heiss, JD;Patronas, N;Oldfield, EH
通讯作者：
Oldfield, EH
影响因子：
0.7
作者：
Bloomfield, IG;Johnston, IH;Bilston, LE
通讯作者：
Bilston, LE
DOI：
10.1115/1.4005849
发表时间：
2012-03-01
影响因子：
1.7
作者：
Elliott, N. S. J.
通讯作者：
Elliott, N. S. J.
影响因子：
19.7
作者：
BRADLEY, WG;KORTMAN, KE;BURGOYNE, B
通讯作者：
BURGOYNE, B