Evidence map›Paper›PMID 42665839›Full record

ArticleFluids and barriers of the CNS2026

Pulsatile intraspinal pressure drives post-traumatic syringomyelia: evidence supporting the CSF pulsatile pressure dynamic equilibrium hypothesis.

Chenghua Yuan, Fan Yuan, Chao Chang, Jiachen Wang, Zuowei Wang, Xingwen Wang, Hao Wu, Zan Chen, Fengzeng Jian, Jian Guan

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In one paragraph

Article in Fluids and barriers of the CNS, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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4 · The record

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5 · Who and what money

Authors and funding

10 authors.

Chenghua YuanDepartment of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.
Fan YuanDepartment of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.
Chao ChangDepartment of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.
Jiachen WangDepartment of Neuro-oncology, Cancer Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Zuowei WangDepartment of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.
Xingwen WangDepartment of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.
Hao WuDepartment of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.
Zan ChenDepartment of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.
Fengzeng JianDepartment of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China. jianfengzeng@xwh.ccmu.edu.cn.
Jian GuanDepartment of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China. guanjian@xwh.ccmu.edu.cn.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveRecent discoveries focused on the role of intraspinal pressure (ISP) in metabolite clearance after spinal cord injury (SCI) have initiated intense research on CSF inflow and outflow pathways. This study aimed to investigate whether the pulsatile ISP wave serves as the primary driver of posttraumatic syringomyelia (PTS) formation and progression, and to determine if a novel subarachnoid‑subarachnoid (S‑S) bypass procedure can effectively attenuate this abnormal pulsatile ISP wave in affected PTS patients.

methodsIn this prospective cohort study of patients with PTS, ISP across the injury site was monitored intraoperatively both before and after placement of the S-S bypass tube. Neurological impairment was assessed using standardized scales at baseline, one year postoperatively, and at the final follow-up. A logistic regression model was used to analyze prognostic factors associated with surgical outcomes.

resultAll 64 enrolled patients underwent S-S bypass surgery; 54 (84.4%) had a history of incomplete SCI. After a mean follow-up of 23.6 months (range: 12-36 months), 46 patients (71.9%) showed neurological improvement. Multivariate logistic regression identified three independent predictors of positive recovery: the pre-bypass ISP gradient across the injury site (OR = 2.228, P = 0.036), the pre-bypass ISP amplitude measured cranial to the injury site (OR = 4.269, P = 0.031) and a bypass tube spanning vertebral levels (OR = 0.331, P = 0.020). Receiver operating characteristic (ROC) curve analysis determined the optimal predictive cut-offs for these parameters. A pre-bypass ISP gradient > 1.5 mmHg showed a sensitivity of 93.48% and a specificity of 66.67%, a pre-bypass ISP amplitude measured cranial to the injury site >3.5 mmHg yielded a sensitivity of 82.61% and a specificity of 94.44%, while a bypass spanning < 5.5 vertebral levels showed a sensitivity of 100% and a specificity of 44.44%.

conclusionsS-S bypass procedure can effectively reduce abnormal Pulsatile Pressure Wave in patients with PTS. This study demonstrates that a pre-bypass ISP gradient > 1.5 mmHg across the injury site, a pre-bypass ISP amplitude >3.5 mmHg measured cranial to the injury site and a bypass conduit spanning < 5.5 vertebral levels are strong, independent predictors of neurological recovery after S-S bypass surgery for posttraumatic syringomyelia.

Indexed as

Cerebrospinal Fluid PressureSpinal Cord InjuriesSubarachnoid SpaceSyringomyeliaAdultAgedFemaleHumansMaleMiddle AgedProspective StudiesBypassCerebrospinal fluidHydrocephalusIntraspinal pressurePosttraumatic syringomyeliaSpinal cord injury

Identifiers

PMID42665839
PMCPMC13523516

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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.