Chang H S, Nakagawa H
Department of Neurological Surgery, Aichi Medical University, Aichi-gun, Japan.
J Neurol Neurosurg Psychiatry. 2004 May;75(5):754-7. doi: 10.1136/jnnp.2003.018671.
To apply a theoretical model to analyse the derangement of cerebrospinal fluid (CSF) dynamics in syringomyelia associated with adhesive arachnoiditis.
An electrical circuit model of CSF dynamics in the spine was used. With this model, the derangement of CSF dynamics in adhesive arachnoiditis was simulated. The effects of various surgical procedures were then analysed, such as syringo-subarachnoid shunting, subarachnoid bypass, and foramen magnum decompression.
When CSF flow in the subarachnoid space was obstructed at a certain point, the pressure inside the spinal cord increased in the segment immediately distal to the blockage. This location of increased pressure corresponded to the preferred site of syrinx formation in adhesive arachnoiditis. Syringo-subarachnoid shunting, subarachnoid bypass, and foramen magnum decompression were all effective at reducing this pressure gradient.
Blockage of the spinal subarachnoid CSF pathway produces a relative increase in the pressure inside the spinal cord distal to the blockage point. Repetitive formation of this pressure gradient then induces CSF leakage into the spinal parenchyma, leading to the formation of syringomyelia. Using this model, alternative surgical procedures could be suggested that might be effective in treating this disease.
应用一种理论模型分析与粘连性蛛网膜炎相关的脊髓空洞症中脑脊液（CSF）动力学紊乱情况。
采用脊柱中脑脊液动力学的电路模型。利用该模型模拟粘连性蛛网膜炎中脑脊液动力学的紊乱情况。然后分析各种外科手术的效果，如脊髓空洞 - 蛛网膜下腔分流术、蛛网膜下腔旁路手术和枕骨大孔减压术。
当蛛网膜下腔脑脊液流动在某一点受阻时，脊髓内压力在阻塞点紧邻的远侧节段升高。压力升高的这个位置与粘连性蛛网膜炎中脊髓空洞形成的偏好部位相对应。脊髓空洞 - 蛛网膜下腔分流术、蛛网膜下腔旁路手术和枕骨大孔减压术在降低这种压力梯度方面均有效。
脊髓蛛网膜下腔脑脊液通路的阻塞导致阻塞点远侧脊髓内压力相对升高。这种压力梯度的反复形成进而诱导脑脊液漏入脊髓实质内，导致脊髓空洞症的形成。利用该模型，可以提出可能有效治疗这种疾病的替代外科手术方法。
