Computer Modelling Study to Investigate the Pathogenesis of Syringomyelia Related to Chiari Malformation

脊髓空洞症是一种潜在的灾难性的进行性神经系统疾病，其特征是脊髓内存在充满液体的囊(空洞)。对导致囊肿形成和生长的物理机制缺乏了解是限制目前可用的外科治疗成功的主要因素之一。一般说来，这种情况被认为是由于脑脊液(一种清洗大脑和脊髓的清澈液体)在脊髓内正常运动的障碍所致。关于脊髓空洞症起源的流体力学假说认为，脑脊液循环的异常模式导致了脑囊肿的形成和生长。传统上，这些假说建立在临床观察和简单的物理基础之上。最近，对脊髓腔内脑脊液运动的计算机模拟已经成为了解这种疾病发病机制的另一种方法。本研究采用了这一方法。在现有的研究中使用了各种建模策略；对于这个项目，建议在两个不同的生理近似水平上同时进行建模，从而产生两个模型，每个模型的目的是检查所讨论问题的一个特定方面。对于开发的两个模型，都将添加新的元素，以解决当前理论的局限性。在项目的最后阶段，将进行涉及模型单向耦合的模拟。目的是在脊髓空洞症的发病机制和治疗方法上产生新的想法。然而，建模也将与与脑脊液动力学相关的其他问题相关。

Syringomyelia is a potentially disastrous progressive neurological condition characterised by the presence of fluid-filled cysts (syrinxes) in the spinal cord. The lack of understanding of the physical mechanisms that contribute to the formation and growth of cysts is one of the main factors that limit the success of currently available surgical treatments. Generally, it is believed that the condition originates from impediments to the normal movement of cerebrospinal fluid (a clear liquid that bathes the brain and the spinal cord) in the spinal cavity. Theories that attribute formation and growth of cysts to abnormal patterns of the cerebrospinal fluid circulation are known as hydrodynamic hypotheses on the origins of syringomyelia and they have traditionally been based on clinical observation and simple physical rationale. More recently, computer modelling of the cerebrospinal fluid motion within the spinal cavity has emerged as an alternative approach for gaining insights into the pathogenesis of the condition. This approach is adopted for this study. Various modelling strategies have been used in the existing studies; for this project it is proposed that modelling be conducted simultaneously on two different levels of physiological approximation, resulting in two models, each of which is intended to examine a specific aspect of the problem in question. For both of the models developed, new elements will be added to address the limitations of the current theories. In the final stage of the project, simulations involving one-way coupling of the models will be conducted. The goal is to generate new ideas on the pathogenesis of syringomyelia and the ways in which it can be managed. However, the modelling will also be relevant to other problems related to the dynamics of the cerebrospinal fluid.