Neurospine.
2023 Dec;20(4):1346-1357. 10.14245/ns.2346834.417.
The Physiological Occlusion of the Central Canal May Be a Prerequisite for Syringomyelia Formation
- Jiang C
1,2,3,4 - Wang X1,2,3,4
- Lu C1,2,3,4
- Li Q1,2,3,4
- Ma L1,2,3,4
- Li W1,2,3,4
- Cui S1,2,3,4
- Li K1,2,3,4
- Wang X5
- Feng Y6
- Jian F1,2,3,4
- Affiliations
-
- 1Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
- 2Spine Center, China International Neuroscience Institute (CHINA-INI), Beijing, China
- 3Research Center of Spine and Spinal Cord, Beijing Institute of Brain Disorders, Capital Medical University, Beijing, China
- 4Lab of Spinal Cord Injury and Functional Reconstruction, China International Neuroscience Institute (CHINA-INI), Xuanwu Hospital, Capital Medical University, Beijing, China
- 5Department of General Surgery, Xuanwu Hospital, Capital Medical University, Beijing, China
- 6Capital Medical University, Beijing, China
- KMID: 2549859
- DOI: http://doi.org/10.14245/ns.2346834.417
Abstract
Objective
Syringomyelia is a common central nervous system disease characterized by the dilation of the central canal (CC). Regarding the pathogenesis of syringomyelia, cerebrospinal fluid (CSF) circulation obstruction in the subarachnoid space (SAS) of the spinal cord has been widely accepted. However, clinical and animal studies on obstructing the CSF in SAS failed to form syringomyelia, challenging the theory of SAS obstruction. The precise pathogenesis remains unknown.
Methods
We utilized an extradural compression rat model to investigate the pathogenesis underlying syringomyelia. Magnetic resonance imaging enabled detection of syringomyelia formation. To assess CSF flow within the SAS, Evans blue was infused into the cisterna magna. Histological analysis allowed morphological examination of the CC. Furthermore, CSF flow through the CC was traced using Ovalbumin Alexa-Flour 647 conjugate (OAF-647). Scanning electron microscopy (SEM) enabled visualization of ependymal cilia.
Results
The findings showed that the dura mater below the compression segment exhibited lighter coloration relative to the region above the compression, indicative of partial obstruction within the SAS. However, the degree of SAS occlusion did not significantly differ between syringomyelia (SM-Y group) and those without (SM-N group). Intriguingly, hematoxylin and eosin staining and CSF tracing revealed occlusion of the CC accompanied by reduced CSF flow in the SM-Y group compared to SM-N and control groups. SEM images uncovered impairment of ependymal cilia inside the syringomyelia.
Conclusion
CC occlusion may represent a physiological prerequisite for syringomyelia formation, while SAS obstruction serves to initiate disease onset. The impairment of ependymal cilia appears to facilitate progression of syringomyelia.
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