Research Update

To date, 2012 has been another successful year for Column of Hope (COH) research. There are two main arms of our research.

1. The first arm of our research involves solving the mystery that has eluded scientists for more than 460 years.
   1. How do canicular syrinxes form?
   2. How does cerebral spinal fluid (CSF) penetrate the closed system of the spinal cord to cause syringomyelia (SM)?
   3. How does CSF travel from the low pressure environment outside the spinal cord to high pressure inside the cord?
   4. Exactly how does Chiari malformation (CM) cause SM?

With our Oslo study in its final stages, we are hoping that it will be the first ever to model CM blockage-induced turbulence in CSF flow. We believe that this turbulence may compromise tissue, and create an opportunity for CSF to enter the closed system of the spinal cord. Our related work of how damage to the blood spinal cord barrier correlates to syrinx formation has just been accepted for publication in a major journal.

In 2010, the preliminary findings of our “Out-of-Phase” study, which was conducted in Sydney, Australia, was featured on the cover of the Journal of Neurosurgery. This study has identified a phenomenon in which the CSF pulse is out of phase with arterial pulse, presumably because of the blockage caused by CM. Our simulations indicate that as the pulse waves become a certain degree out of phase, the pressure on the inside of the cord is less than the pressure outside of the cord. In January of 2012, the Journal of Biomechanics published our related study, which indicates that arachnoiditis also has the ability to induce this “out-of-phase” state. Peer reviewers have asked us to increase our sample size slightly, after which we expect that the completed study will be published later this year. At that time, we plan to partner with SUNY Buffalo’s Department of Translational Research in order to apply for an NIH grant to conduct a multi-facility study to verify and expand our findings.

We believe the combination of the turbulence and “Out-of-Phase” studies will finally answer the 460 year mystery of how CM causes SM!

1. The second arm of our research deals with the formation, and hopefully prevention, of SM after spinal cord injury, which is referred to as post traumatic SM (PTSM).
   1. This month’s issue of Neurosurgery includes the publication of our study on a principle method for tracking the direction of CSF leaving the syrinx. This marks COH’s 8th credit on a scholarly research study published in a peer reviewed journal.
   2. This method is particularly important to us, as our 2012 study is focused on varying the concentrations of certain substances near a damaged spinal cord to potentially protect the cord from SM. We are hoping for a tremendous by-product of this study. This research on tracking CSF could potentially lead to a non-surgical procedure for extracting CSF from the syrinx.

As both arms of our research converge, we begin to approach an answer about how a syrinx forms. The research we have helped to fund will be featured at two international conferences in the coming months, Conquer Chiari’s Chiari Conference in Chicago, and Dr. Stoodley’s Syringomyelia Conference in Sydney. We are co-sponsors of each event in order to encourage collaboration among the world’s leading CM/SM researchers.

Recently, we have begun to see delays and cost concerns in our research (and the research of others) dealing with the simulation of CSF flow. The world-wide shortage of supercomputer time is actually slowing down CM/SM research. To help ameliorate the problem, we are working with a development stage company in WNY. They appear to have developed a low cost solution using “mini supercomputers” to run the simulations that these researchers have created. We are at the Beta test stage of using these new computer systems to process CSF simulations. We are hopeful that COH can once again add value to our researchers’ efforts, in order to reduce the time it takes our research to improve outcomes for CM/SM patients.

In 2010, COH was credited on a publication of a study from The Chiari Institute on Long Island which dealt with how to assist neurosurgeons in determining the cause of the CM that a particular patient has. Our goal was to have a tool for every neurosurgeon to use, before operating, in order to select the best suited surgical procedure. Continuing with that effort to bring the most recent research into the hands of the surgeons in the field, we have asked our Primary Investigator and honored neurosurgeon, Marcus Stoodley Ph.D. FRACS, from Sydney, to present the latest diagnostic and treatment techniques for CM/SM patients to WNY physicians.

Catholic Health System has been kind enough to organize a physician CME program at 8:30 AM at South Buffalo Mercy Hospital on October 13, 2012 (the morning of our Gala) to accommodate Dr. Stoodley’s presentation. Physician reservation information will be released soon. Dr. Stoodley will also be the featured speaker at our 10th Annual “Working Toward a Day Without Pain” Gala, which starts at 6 PM at the Hyatt Regency. Please contact mkane@kanefirm.com if you would like to join us.

We are pleased with our 2012 results in both arms of our research, but we continue to be impatient. Our efforts are constantly focused, with the help of our volunteer scientific advisor, Dr. Lee Guterman, on determining which projects will have the most payback, and how we can use our resources to speed the translation of our research to tools to improve outcomes for CM, SM, and related disorders patients. We thank our supporters who have made the current progress possible and future progress achievable!

Mark S. Kane, President Column of Hope