Investigations of cerebrospinal fluid flow in extracanalicular syringomyelia.

脊髓囊肿(脊髓空洞症)发生在患有先天性脊髓畸形(如脊柱裂)的儿童和年轻人，以及在脊髓损伤或脑膜炎后的所有年龄段的人中。脊髓空洞症会引起疼痛和瘫痪，即使经过治疗通常也不会改善。目前对脊髓囊肿形成和扩大的机制缺乏了解，阻碍了有效治疗方法的发展。我们之前已经证明，某些类型的脊髓囊肿是通过脊髓周围的正常液体通过小动脉泵入脊髓中心而扩大的。创伤后脊髓囊肿扩大的机制尚不清楚，这种使人衰弱的脊髓空洞症仍然难以治疗。我们的假设是，创伤后的脊髓囊肿也会通过围绕小动脉周围的液体被泵入其中而扩大。另一种假设是，减少动脉搏动和脊髓周围液体中的压力将防止或抑制囊肿扩大。这些假说将通过检测创伤后脊髓空洞症大鼠和绵羊模型中的液体流动来检验。我们已经在大鼠身上建立了创伤后脊髓空洞症的模型，该项目的第一阶段将是完善和表征这个模型，并在绵羊身上复制它。第二阶段将确定这些囊肿是否像其他类型的脊髓空洞症那样，通过动脉搏动驱动小动脉周围的液体流动而扩大。最后一个阶段将是确定降低脊髓周围液体中的压力是否可以防止囊肿扩大。证实这些技术可以防止囊肿扩大，将为治疗人类脊髓空洞症开辟新的可能性。

Cysts in the spinal cord (syringomyelia) develop in children and young adults with congenital spinal cord abnormalities such as spina bifida, and in people of all ages after spinal cord injury or meningitis. Syringomyelia causes pain and paralysis that usually does not improve even with treatment. The current lack of knowledge about the mechanism of spinal cord cyst formation and enlargement is preventing the development of effective therapy. We have previously shown that some types of spinal cord cysts enlarge by the normal fluid surrounding the spinal cord being pumped around small arteries into the centre of the spinal cord. The mechanism of enlargement of post-traumatic spinal cord cysts remains unknown, and this debilitating type of syringomyelia remains difficult to treat. Our hypothesis is that post-traumatic spinal cord cysts also enlarge by fluid being pumped into them around small arteries. A further hypothesis is that reductions of arterial pulsations and of the pressure in the fluid surrounding the spinal cord will prevent or inhibit cyst enlargement. These hypotheses will be tested by examining fluid flow in models of post-traumatic syringomyelia in rats and sheep. We have established a model of post-traumatic syringomyelia in rats and the first phase of the project will be to refine and characterize this model and to reproduce it in sheep. The second phase will be to determine whether these cysts enlarge by a flow of fluid around small arteries that is driven by arterial pulsations, as they do in other types of syringomyelia. The final phase will be to determine whether reducing the pressure in the fluid around the spinal cord prevents cyst enlargement. Confirmation that these techniques prevent cyst enlargement would open up new possibilities for the treatment of human syringomyelia.