Cirovic Srdjan, Lloyd Robert, Jovanovik Jelena, Volk Holger A, Rusbridge Clare
The Centre for Biomedical Engineering, University of Surrey, Guildford, GU2 7XH, UK.
Neuroscience Research Australia and Prince of Wales Clinical School, University of New South Wales, Sydney, NSW, 2031, Australia.
BMC Vet Res. 2018 Mar 9;14(1):82. doi: 10.1186/s12917-018-1410-7.
Syringomyelia is a pathological condition in which fluid-filled cavities (syringes) form and expand in the spinal cord. Syringomyelia is often linked with obstruction of the craniocervical junction and a Chiari malformation, which is similar in both humans and animals. Some brachycephalic toy breed dogs such as Cavalier King Charles Spaniels (CKCS) are particularly predisposed. The exact mechanism of the formation of syringomyelia is undetermined and consequently with the lack of clinical explanation, engineers and mathematicians have resorted to computer models to identify possible physical mechanisms that can lead to syringes. We developed a computer model of the spinal cavity of a CKCS suffering from a large syrinx. The model was excited at the cranial end to simulate the movement of the cerebrospinal fluid (CSF) and the spinal cord due to the shift of blood volume in the cranium related to the cardiac cycle. To simulate the normal condition, the movement was prescribed to the CSF. To simulate the pathological condition, the movement of CSF was blocked.
For normal conditions the pressure in the SAS was approximately 400 Pa and the same applied to all stress components in the spinal cord. The stress was uniformly distributed along the length of the spinal cord. When the blockage between the cranial and spinal CSF spaces forced the cord to move with the cardiac cycle, shear and axial normal stresses in the cord increased significantly. The sites where the elevated stress was most pronounced coincided with the axial locations where the syringes typically form, but they were at the perimeter rather than in the central portion of the cord. This elevated stress originated from the bending of the cord at the locations where its curvature was high.
The results suggest that it is possible that repetitive stressing of the spinal cord caused by its exaggerated movement could be a cause for the formation of initial syringes. Further consideration of factors such as cord tethering and the difference in mechanical properties of white and grey matter is needed to fully explore this possibility.
脊髓空洞症是一种病理状态,其中充满液体的空洞(脊髓空洞)在脊髓中形成并扩大。脊髓空洞症常与颅颈交界区梗阻和Chiari畸形有关,这在人类和动物中都很相似。一些短头玩具犬种,如骑士查理王小猎犬(CKCS)特别易患此病。脊髓空洞症形成的确切机制尚未确定,因此由于缺乏临床解释,工程师和数学家求助于计算机模型来确定可能导致空洞形成的物理机制。我们建立了一只患有大空洞的CKCS脊髓腔的计算机模型。该模型在颅端受到刺激,以模拟由于与心动周期相关的颅骨血容量变化导致的脑脊液(CSF)和脊髓的运动。为了模拟正常情况,规定了CSF的运动。为了模拟病理情况,阻断了CSF的运动。
在正常情况下,蛛网膜下腔(SAS)中的压力约为400 Pa,脊髓中所有应力分量的压力相同。应力沿脊髓长度均匀分布。当颅部和脊髓CSF空间之间的阻塞迫使脊髓随心动周期移动时,脊髓中的剪切应力和轴向正应力显著增加。应力升高最明显的部位与通常形成空洞的轴向位置一致,但它们位于脊髓的周边而非中央部分。这种应力升高源于脊髓在曲率高的位置的弯曲。
结果表明,脊髓过度运动引起的反复应力作用可能是初始空洞形成的原因。需要进一步考虑诸如脊髓束缚以及白质和灰质力学性能差异等因素来充分探讨这种可能性。