The role of spinal cord pulsatility in the pathogenesis of Post-traumatic syringomyelia: A novel hypothesis

IF 1 4区医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL

Medical hypotheses Pub Date : 2026-04-01 Epub Date: 2026-02-24 DOI:10.1016/j.mehy.2026.111924

Feifan Xu , Fengzeng Jian , Jian Guan , Zhiqiang Yi , Xingwen Wang

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Abstract

This paper proposes a novel hypothesis that impaired spinal cord pulsatility is a critical factor in the pathogenesis of post-traumatic syringomyelia (PTS). Beyond established theories on cerebrospinal fluid dynamics and intramedullary changes, we posit that post-traumatic adhesions and compression diminish spinal cord motion and compliance. This loss of normal kinematics disrupts fluid homeostasis, facilitating syrinx formation and progression. Supporting evidence includes consistent intraoperative observation of reduced pulsatility in PTS, which improves after decompression and adhesion release, correlating with syrinx collapse. Literature confirms pulsatility’s role in cord protection and cerebrospinal fluid dynamics. If validated, this hypothesis reframes PTS pathophysiology, suggesting spinal cord pulsatility as a biomarker for diagnosis, a real-time surgical guide for decompression, and a target for future therapies aimed at restoring mechanical homeostasis.

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脊髓搏动在创伤后脊髓空洞发病机制中的作用：一个新的假说

本文提出了一个新的假设，即脊髓搏动功能受损是创伤后脊髓空洞症（PTS）发病的关键因素。除了脑脊液动力学和髓内变化的既定理论外，我们假设创伤后粘连和压迫会减少脊髓的运动和顺应性。这种正常运动学的丧失破坏了流体稳态，促进了鼻窦的形成和发展。支持性证据包括术中一致观察到PTS患者搏动性降低，减压和粘连释放后搏动性改善，与鼻管塌陷相关。文献证实了搏动在脊髓保护和脑脊液动力学中的作用。如果得到证实，这一假设将重新构建PTS病理生理学，表明脊髓搏动可作为诊断的生物标志物、减压的实时手术指南，以及旨在恢复机械稳态的未来治疗目标。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Medical hypotheses 医学-医学：研究与实验

CiteScore

10.60

自引率

2.10%

发文量

167

审稿时长

60 days

期刊介绍： Medical Hypotheses is a forum for ideas in medicine and related biomedical sciences. It will publish interesting and important theoretical papers that foster the diversity and debate upon which the scientific process thrives. The Aims and Scope of Medical Hypotheses are no different now from what was proposed by the founder of the journal, the late Dr David Horrobin. In his introduction to the first issue of the Journal, he asks ''what sorts of papers will be published in Medical Hypotheses? and goes on to answer ''Medical Hypotheses will publish papers which describe theories, ideas which have a great deal of observational support and some hypotheses where experimental support is yet fragmentary''. (Horrobin DF, 1975 Ideas in Biomedical Science: Reasons for the foundation of Medical Hypotheses. Medical Hypotheses Volume 1, Issue 1, January-February 1975, Pages 1-2.). Medical Hypotheses was therefore launched, and still exists today, to give novel, radical new ideas and speculations in medicine open-minded consideration, opening the field to radical hypotheses which would be rejected by most conventional journals. Papers in Medical Hypotheses take a standard scientific form in terms of style, structure and referencing. The journal therefore constitutes a bridge between cutting-edge theory and the mainstream of medical and scientific communication, which ideas must eventually enter if they are to be critiqued and tested against observations.