ArticlePloS one2017
A numerical investigation of intrathecal isobaric drug dispersion within the cervical subarachnoid space.
Article in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
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Who cites it
21 citing papers in PubMed, 34 citations in OpenAlex.
- Minimum Local Anesthetic Dose of Ropivacaine in Cesarean Section for Real-Time Ultrasound-Guided Spinal Anesthesia Using 24-Gauge versus 26-Gauge Needles Based on Fluid Simulation Technology: A Randomized Controlled Trial.Drug design, development and therapy · 2024Trial
- Modeling glioma-induced impairments on the glymphatic system.Fluids and barriers of the CNS · 2026Article
- A 3D non-human primate digital model for pharmacokinetic prediction of intra-cerebrospinal fluid drug neuraxial dispersion.Fluids and barriers of the CNS · 2025Article
- The Effect of Injection Parameters on Drug Distribution for Spinal Anesthesia: A Numerical Approach.Journal of clinical medicine · 2025Article
- Rebuttal Letter to the Editor: Defending Evidence-Based Practices in Interventional Pain Medicine [Letter].Journal of pain research · 2025Article
- Case Report: Lateral C1-C2 puncture for intrathecal baclofen therapy: an alternative effective and safe approach after spinal cord injury.Frontiers in pain research (Lausanne, Switzerland) · 2025Article
- Numerical study of the effects of minor structures and mean velocity fields in the cerebrospinal fluid flow.Fluids and barriers of the CNS · 2024Article
- Magnetically Guided Microcatheter for Targeted Injection of Magnetic Particle Swarms.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2024Article
- Effects of buoyancy on the dispersion of drugs released intrathecally in the spinal canal.Journal of fluid mechanics · 2024Article
- In vivo distribution of cerebrospinal fluid tracer in human upper spinal cord and brain stem.JCI insight · 2023Article
- Determination of spinal tracer dispersion after intrathecal injection in a deformable CNS model.Frontiers in physiology · 2023Article
- Intrathecal amyloid-beta oligomer administration increases tau phosphorylation in the medial temporal lobe in the African green monkey: A nonhuman primate model of Alzheimer's disease.Neuropathology and applied neurobiology · 2022Article
- Translational Approaches for Brain Delivery of Biologics via Cerebrospinal Fluid.Clinical pharmacology and therapeutics · 2022Review
- Human in silico trials for parametric computational fluid dynamics investigation of cerebrospinal fluid drug delivery: impact of injection location, injection protocol, and physiology.Fluids and barriers of the CNS · 2022Article
- Investigation of Human Intrathecal Solute Transport Dynamics Using a NovelFrontiers in neuroimaging · 2022Article
- Direction and magnitude of cerebrospinal fluid flow vary substantially across central nervous system diseases.Fluids and barriers of the CNS · 2021Article
- Impact of Neurapheresis System on Intrathecal Cerebrospinal Fluid Dynamics: A Computational Fluid Dynamics Study.Journal of biomechanical engineering · 2020Article
- Dispersion in porous media in oscillatory flow between flat plates: applications to intrathecal, periarterial and paraarterial solute transport in the central nervous system.Fluids and barriers of the CNS · 2019Article
- Anthropomorphic Model of Intrathecal Cerebrospinal Fluid Dynamics Within the Spinal Subarachnoid Space: Spinal Cord Nerve Roots Increase Steady-Streaming.Journal of biomechanical engineering · 2018Article
- An MRI-Compatible Hydrodynamic Simulator of Cerebrospinal Fluid Motion in the Cervical Spine.IEEE transactions on bio-medical engineering · 2018Article
Corrections and comments
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Authors and funding
8 authors at 5 institutions in 3 countries.
Funding
Abstract
Intrathecal drug and gene vector delivery is a procedure to release a solute within the cerebrospinal fluid. This procedure is currently used in clinical practice and shows promise for treatment of several central nervous system pathologies. However, intrathecal delivery protocols and systems are not yet optimized. The aim of this study was to investigate the effects of injection parameters on solute distribution within the cervical subarachnoid space using a numerical platform. We developed a numerical model based on a patient-specific three dimensional geometry of the cervical subarachnoid space with idealized dorsal and ventral nerve roots and denticulate ligament anatomy. We considered the drug as massless particles within the flow field and with similar properties as the CSF, and we analyzed the effects of anatomy, catheter position, angle and injection flow rate on solute distribution within the cerebrospinal fluid by performing a series of numerical simulations. Results were compared quantitatively in terms of drug peak concentration, spread, accumulation rate and appearance instant over 15 seconds following the injection. Results indicated that solute distribution within the cervical spine was altered by all parameters investigated within the time range analyzed following the injection. The presence of spinal cord nerve roots and denticulate ligaments increased drug spread by 60% compared to simulations without these anatomical features. Catheter position and angle were both found to alter spread rate up to 86%, and catheter flow rate altered drug peak concentration up to 78%. The presented numerical platform fills a first gap towards the realization of a tool to parametrically assess and optimize intrathecal drug and gene vector delivery protocols and systems. Further investigation is needed to analyze drug spread over a longer clinically relevant time frame.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.