Bessen Madeleine Amy, Gayen Christine Diana, Doig Ryan L O'Hare, Dorrian Ryan Michael, Quarrington Ryan David, Mulaibrahimovic Adnan, Kurtcuoglu Vartan, Walls Angela Catherine, Leonard Anna Victoria, Jones Claire Frances
Adelaide Spinal Research Group & Centre for Orthopaedics and Trauma Research, Faculty of Health and Medical Sciences, The University of Adelaide, Level 7, Adelaide Health and Medical Sciences Building, North Terrace, Adelaide, SA, 5005, Australia.
Adelaide Medical School, The University of Adelaide, Level 7, Adelaide Health and Medical Sciences Building, The University of Adelaide, North Terrace, Adelaide, SA, 5005, Australia.
Fluids Barriers CNS. 2025 Jan 14;22(1):6. doi: 10.1186/s12987-024-00595-9.
Traumatic spinal cord injury (SCI) causes spinal cord swelling and occlusion of the subarachnoid space (SAS). SAS occlusion can change pulsatile cerebrospinal fluid (CSF) dynamics, which could have acute clinical management implications. This study aimed to characterise SAS occlusion and investigate CSF dynamics over 14 days post-SCI in the pig.
A thoracic contusion SCI was induced in female domestic pigs (22-29 kg) via a weight drop apparatus (N = 5, 10 cm; N = 5, 20 cm). Magnetic resonance imaging (MRI) was performed pre-SCI and 3, 7 and 14 days post-SCI. SAS occlusion length (cranial-caudal), and injury site SAS area (cross-sectional), were measured on T2-weighted MRI. CSF dynamics, specifically peak cranial/caudal mean velocity (cm/s), and the corresponding time to peak (% of cardiac cycle), were measured on cardiac gated, axial phase-contrast MRI obtained at C2/C3, T8/T9, T11/T12 and L1/L2. Linear-mixed effects models, with a significance level of α = 0.05, were developed to assess the effect of: (1) injury group and time point on SAS occlusion measures; and (2), time point and spinal level, adjusted by injury group, on CSF dynamics.
For both injury groups, SAS occlusion length decreased from 3 to 7 days post-SCI, and 7 to 14 days post-SCI. The cross-sectional SAS area decreased after SCI, and increased to 14 days post-SCI, in both groups. At all spinal levels, peak cranial/caudal mean velocity and the time to peak caudal mean velocity decreased at day 3 post-SCI. From 3 to 14 days post-SCI, peak caudal mean velocity and the time to peak caudal mean velocity increased towards baseline values, at all spinal levels.
Spinal-level specific changes to CSF dynamics, with concurrent changes to SAS occlusion, occurred after SCI in the pig, suggesting that CSF pulsatility and craniospinal compliance were altered in the sub-acute post-traumatic period. These results suggest that PC-MRI derived CSF dynamics may provide a non-invasive method to investigate functional alterations to the spinal intrathecal space following traumatic SCI.
创伤性脊髓损伤（SCI）会导致脊髓肿胀和蛛网膜下腔（SAS）闭塞。SAS闭塞会改变搏动性脑脊液（CSF）动力学，这可能对急性临床管理产生影响。本研究旨在描述SAS闭塞情况，并研究猪SCI后14天内的CSF动力学。
通过重物坠落装置对雌性家猪（22 - 29千克）造成胸椎挫伤性SCI（n = 5，10厘米；n = 5，20厘米）。在SCI前以及SCI后3天、7天和14天进行磁共振成像（MRI）检查。在T2加权MRI上测量SAS闭塞长度（头端 - 尾端）和损伤部位的SAS面积（横截面）。在C2/C3、T8/T9、T11/T12和L1/L2水平获取的心脏门控轴向相位对比MRI上测量CSF动力学，具体为头端/尾端平均峰值速度（厘米/秒）以及达到峰值的相应时间（心动周期的百分比）。建立显著性水平α = 0.05的线性混合效应模型，以评估以下因素的影响：（1）损伤组和时间点对SAS闭塞测量的影响；（2）经损伤组调整后的时间点和脊髓水平对CSF动力学的影响。
对于两个损伤组，SAS闭塞长度在SCI后3至7天以及7至14天均有所下降。两组中SCI后SAS的横截面面积均减小，并在SCI后14天增加。在所有脊髓水平，SCI后第3天头端/尾端平均峰值速度和尾端平均峰值速度达到峰值的时间均下降。从SCI后3天至14天，所有脊髓水平的尾端平均峰值速度和尾端平均峰值速度达到峰值的时间均朝着基线值增加。
猪SCI后发生了脊髓水平特异性的CSF动力学变化，同时伴有SAS闭塞的改变，这表明在创伤后亚急性期CSF搏动性和颅脊髓顺应性发生了改变。这些结果表明，基于PC - MRI的CSF动力学可能提供一种非侵入性方法来研究创伤性SCI后脊髓鞘内空间的功能改变。
