Universität zu Köln

Pahlavian, Soroush Heidari, Yiallourou, Theresia, Tubbs, R. Shane, Bunck, Alexander C., Loth, Francis, Goodin, Mark, Raisee, Mehrdad and Martin, Bryn A. ORCID: 0000-0003-1234-7880 (2014). The Impact of Spinal Cord Nerve Roots and Denticulate Ligaments on Cerebrospinal Fluid Dynamics in the Cervical Spine. PLoS One, 9 (4). SAN FRANCISCO: PUBLIC LIBRARY SCIENCE. ISSN 1932-6203

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Abstract

Cerebrospinal fluid (CSF) dynamics in the spinal subarachnoid space (SSS) have been thought to play an important pathophysiological role in syringomyelia, Chiari I malformation (CM), and a role in intrathecal drug delivery. Yet, the impact that fine anatomical structures, including nerve roots and denticulate ligaments (NRDL), have on SSS CSF dynamics is not clear. In the present study we assessed the impact of NRDL on CSF dynamics in the cervical SSS. The 3D geometry of the cervical SSS was reconstructed based on manual segmentation of MRI images of a healthy volunteer and a patient with CM. Idealized NRDL were designed and added to each of the geometries based on in vivo measurments in the literature and confirmation by a neuroanatomist. CFD simulations were performed for the healthy and patient case with and without NRDL included. Our results showed that the NRDL had an important impact on CSF dynamics in terms of velocity field and flow patterns. However, pressure distribution was not altered greatly although the NRDL cases required a larger pressure gradient to maintain the same flow. Also, the NRDL did not alter CSF dynamics to a great degree in the SSS from the foramen magnum to the C1 level for the healthy subject and CM patient with mild tonsillar herniation (similar to 6 mm). Overall, the NRDL increased fluid mixing phenomena and resulted in a more complex flow field. Comparison of the streamlines of CSF flow revealed that the presence of NRDL lead to the formation of vortical structures and remarkably increased the local mixing of the CSF throughout the SSS.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Pahlavian, Soroush Heidari UNSPECIFIED UNSPECIFIED UNSPECIFIED Yiallourou, Theresia UNSPECIFIED UNSPECIFIED UNSPECIFIED Tubbs, R. Shane UNSPECIFIED UNSPECIFIED UNSPECIFIED Bunck, Alexander C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Loth, Francis UNSPECIFIED UNSPECIFIED UNSPECIFIED Goodin, Mark UNSPECIFIED UNSPECIFIED UNSPECIFIED Raisee, Mehrdad UNSPECIFIED UNSPECIFIED UNSPECIFIED Martin, Bryn A. UNSPECIFIED orcid.org/0000-0003-1234-7880 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-440847
DOI:	10.1371/journal.pone.0091888
Journal or Publication Title:	PLoS One
Volume:	9
Number:	4
Date:	2014
Publisher:	PUBLIC LIBRARY SCIENCE
Place of Publication:	SAN FRANCISCO
ISSN:	1932-6203
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language COMPUTATIONAL FLOW-ANALYSIS; CHIARI-I MALFORMATION; SUBARACHNOID SPACE; FORAMEN MAGNUM; CSF FLOW; PRESSURE RECORDINGS; VEIN GRAFTS; SYRINGOMYELIA; HYDRODYNAMICS; ANATOMY Multiple languages Multidisciplinary Sciences Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/44084