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Song X, Gong J, Yu SB, Yang H, Song Y, Zhang XH, Zhang J, Hack GD, Li TL, Chi YY, Zheng N, Sui HJ. The relationship between compensatory hyperplasia of the myodural bridge complex and reduced compliance of the various structures within the cranio-cervical junction. Anat Rec (Hoboken) 2023; 306:401-408. [PMID: 35808865 PMCID: PMC10084404 DOI: 10.1002/ar.25040] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 05/24/2022] [Accepted: 06/30/2022] [Indexed: 01/25/2023]
Abstract
The myodural bridge complex (MDBC) is described as a functional anatomic structure that involves the dense connective tissue fibers, muscles, and ligaments in the suboccipital region. It has recently been proposed that the MDBC can influence cerebrospinal fluid (CSF) circulation. In the present study, bleomycin (BLM), a type of antibiotic that is poisonous to cells, was injected into the posterior atlanto-occipital interspace (PAOiS) of rats to induce fibrous hyperplasia of structures in PAOiS. Sagittal sections of tissues obtained from the posterior-occipital region of the rats were stained utilizing the Masson Trichrome staining method. Semiquantitative analysis evidenced that the collagen volume fraction of collagen fibers of the MDBC, as well as the sum of the area of the spinal dura mater and the posterior atlanto-occipital membrane in the BLM group were significantly increased (p < .05) compared to that of the other groups. This finding illustrates that the MDBC fibers as well as other tissues in the PAOiS of rats in the BLM group developed fibrotic changes which reduced compliance of the spinal dura mater. Indeed, the sectional area of the rectus capitis dorsal minor muscle in the BLM group was measured to be increased. These changes may further restrict CSF flow. The present research provides support for the recent hypothesis proposed by Labuda et al. concerning the pathophysiology observed in symptomatic adult Chiari malformation Type I patients, that there exists a relationship between the altered compliance of the anatomic structures within the craniocervical region and the resultant compensatory hyperplasia of the MDBC.
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Affiliation(s)
- Xue Song
- Department of Anatomy, College of Basic Medicine, Dalian Medical University, Dalian, China
| | - Jin Gong
- Department of Anatomy, College of Basic Medicine, Dalian Medical University, Dalian, China
| | - Sheng-Bo Yu
- Department of Anatomy, College of Basic Medicine, Dalian Medical University, Dalian, China
| | - Heng Yang
- Department of Anatomy, College of Basic Medicine, Dalian Medical University, Dalian, China
| | - Yang Song
- Department of Anatomy, College of Basic Medicine, Dalian Medical University, Dalian, China
| | - Xu-Hui Zhang
- Department of Anatomy, College of Basic Medicine, Dalian Medical University, Dalian, China
| | - Jing Zhang
- Department of Anatomy, College of Basic Medicine, Dalian Medical University, Dalian, China
| | - Gary D Hack
- Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry, Baltimore, Maryland, USA
| | - Tai-Lai Li
- The Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Yan-Yan Chi
- Department of Anatomy, College of Basic Medicine, Dalian Medical University, Dalian, China
| | - Nan Zheng
- Department of Anatomy, College of Basic Medicine, Dalian Medical University, Dalian, China
| | - Hong-Jin Sui
- Department of Anatomy, College of Basic Medicine, Dalian Medical University, Dalian, China
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Chien K, Keehn W, Scali F. The relationship between the myodural bridge, vertebrodural structures, and idiopathic cerebrospinal fluid leaks in whiplash injuries. Med Hypotheses 2022; 165:110902. [DOI: 10.1016/j.mehy.2022.110902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Scali F, Ohno A, Enix D, Hassan S. The Posterior Atlantooccipital Membrane: The Anchor for the Myodural Bridge and Meningovertebral Structures. Cureus 2022; 14:e25484. [PMID: 35686279 PMCID: PMC9170425 DOI: 10.7759/cureus.25484] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/29/2022] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION Sheet plastination has provided evidence that the posterior atlantooccipital membrane attaches to the dura's posterior sleeve at the cerebrospinal junction. These findings contradict the traditional anatomical description of this membrane extending from the atlas' posterior arch to the foramen magnum. METHODS A total of 16 plastinated cadavers were studied to evaluate the in situ and gross configuration of the posterior atlantooccipital membrane. Fifteen cadavers underwent sheet plastination, and one head was hemisected and plastinated. In all specimens, stereomicroscopy was used to evaluate the posterior atlantooccipital membrane and related structures within the intervertebral and epidural spaces. RESULTS In all 16 specimens, the posterior atlantooccipital membrane extending from the occiput, merged with the craniocervical dura mater, and formed a membrane-dura complex that ended at the level of the third cervical vertebra. The superior and inferior myodural bridge coalesced with their respective vertebrodural ligaments and fused with the posterior atlantooccipital membrane at their respective interspaces. CONCLUSION The median aspect of the posterior atlantooccipital membrane does not directly communicate with the posterior arch of the atlas. Instead, the posterior atlantooccipital membrane converges with the craniocervical dura mater and terminates at the level of the third cervical vertebra. This membrane-dura complex serves as a common attachment site for the myodural and vertebrodural structures.
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Affiliation(s)
- Frank Scali
- Medical Education and Anatomy, California University of Science and Medicine, Colton, USA
| | - Ai Ohno
- Medicine, California University of Science and Medicine, Colton, USA
| | - Dennis Enix
- Research, Independent Investigator, Ballwin, USA
| | - Sherif Hassan
- Medical Education and Anatomy, California University of Science and Medicine, Colton, USA
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Klinge PM, McElroy A, Donahue JE, Brinker T, Gokaslan ZL, Beland MD. Abnormal spinal cord motion at the craniocervical junction in hypermobile Ehlers-Danlos patients. J Neurosurg Spine 2021; 35:18-24. [PMID: 34020423 DOI: 10.3171/2020.10.spine201765] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 10/23/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The craniocervical junction (CCJ) is anatomically complex and comprises multiple joints that allow for wide head and neck movements. The thecal sac must adjust to such movements. Accordingly, the thecal sac is not rigidly attached to the bony spinal canal but instead tethered by fibrous suspension ligaments, including myodural bridges (MDBs). The authors hypothesized that pathological spinal cord motion is due to the laxity of such suspension bands in patients with connective tissue disorders, e.g., hypermobile Ehlers-Danlos syndrome (EDS). METHODS The ultrastructure of MDBs that were intraoperatively harvested from patients with Chiari malformation was investigated with transmission electron microscopy, and 8 patients with EDS were compared with 8 patients without EDS. MRI was used to exclude patients with EDS and craniocervical instability (CCI). Real-time ultrasound was used to compare the spinal cord at C1-2 of 20 patients with EDS with those of 18 healthy control participants. RESULTS The ultrastructural damage of the collagen fibrils of the MDBs was distinct in patients with EDS, indicating a pathological mechanical laxity. In patients with EDS, ultrasound revealed increased cardiac pulsatory motion and irregular displacement of the spinal cord during head movements. CONCLUSIONS Laxity of spinal cord suspension ligaments and the associated spinal cord motion disorder are possible pathogenic factors for chronic neck pain and headache in patients with EDS but without radiologically proven CCI.
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Affiliation(s)
| | | | | | - Thomas Brinker
- 3Department of Neurosurgery, Medical School Hannover, Germany
| | | | - Michael D Beland
- 4Radiology, Rhode Island Hospital, The Warren Alpert Medical School of Brown University, Providence, Rhode Island; and
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Garcia-Pires F, Jayappa S, Desai S, Ramakrishnaiah RH, Choudhary AK. Spinal subdural hemorrhage in abusive head trauma: a pictorial review. Pediatr Radiol 2021; 51:980-990. [PMID: 33999240 DOI: 10.1007/s00247-020-04931-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 08/27/2020] [Accepted: 12/07/2020] [Indexed: 11/30/2022]
Abstract
A growing body of evidence links abusive head trauma (AHT) to patterns of direct and indirect spinal injuries, such as spinal subdural hemorrhage (SDH). Identification of evidence of spinal injury such as spinal SDH plays a crucial role in the diagnosis and subsequent management of the index child with AHT and his or her siblings. In a value-based practice of medicine, it can be argued that adding spine imaging to identify spinal SDH in the workup of AHT adds value to both the short- and long-term management of the patient. This pictorial review describes the normal appearance of spinal SDH and challenges of identifying spinal SDH, and it explores the mechanism of spinal SDH development in AHT.
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Affiliation(s)
- Flavio Garcia-Pires
- Department of Radiology, University of Arkansas for Medical Sciences (UAMS), 4301 W. Markham St., Slot 556, Little Rock, AR, 72205, USA.
| | - Sateesh Jayappa
- Department of Radiology, University of Arkansas for Medical Sciences (UAMS), 4301 W. Markham St., Slot 556, Little Rock, AR, 72205, USA
| | - Shivang Desai
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Raghu H Ramakrishnaiah
- Department of Radiology, University of Arkansas for Medical Sciences (UAMS), 4301 W. Markham St., Slot 556, Little Rock, AR, 72205, USA
| | - Arabinda K Choudhary
- Department of Radiology, University of Arkansas for Medical Sciences (UAMS), 4301 W. Markham St., Slot 556, Little Rock, AR, 72205, USA
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Sillevis R, Hogg R. Anatomy and clinical relevance of sub occipital soft tissue connections with the dura mater in the upper cervical spine. PeerJ 2020; 8:e9716. [PMID: 32864219 PMCID: PMC7425638 DOI: 10.7717/peerj.9716] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 07/23/2020] [Indexed: 11/29/2022] Open
Abstract
Background The upper cervical region is a complex anatomical structure. Myodural bridges between posterior suboccipital muscles and the dura might be important explaining conditions associated with the upper cervical spine dysfunction such as cervicogenic headache. This cadaver study explored the upper cervical spine and evaluated the myodural bridges along with position of spinal cord in response to passive motion of upper cervical spine. Methods A total of seven adult cadavers were used in this exploratory study. The suboccipital muscles and nuchal ligament were exposed. Connections between the Rectus Capitis Posterior major/minor and the Obliquus Capitis minor, the nuchal ligament, posterior aspect of the cervical spine, flavum ligament and the dura were explored and confirmed with histology. The position of the spinal cord was evaluated with passive motions of the upper cervical spine. Outcomes In all cadavers connective tissues attaching the Rectus Capitis Posterior Major to the posterior atlanto-occipital membrane were identified. In the sagittal dissection we observed connection between the nuchal ligament and the dura. Histology revealed that the connection is collagenous in nature. The spinal cord moves within the spinal canal during passive movement. Discussion The presence of tissue connections between ligament, bone and muscles in the suboccipital region was confirmed. The nuchal ligament was continuous with the menigiovertebral ligament and the dura. Passive upper cervical motion results in spinal cord motion within the canal and possible tensioning of nerve and ligamentous connections.
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Affiliation(s)
- Rob Sillevis
- Department of Rehabilitation Sciences, Florida Gulf Coast University, Fort Myers, FL, USA
| | - Russell Hogg
- Department of Rehabilitation Sciences, Florida Gulf Coast University, Fort Myers, FL, USA
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Sillevis R, Swanick K. Musculoskeletal ultrasound imaging and clinical reasoning in the management of a patient with cervicogenic headache: a case report. Physiother Theory Pract 2019; 37:1252-1262. [PMID: 31686564 DOI: 10.1080/09593985.2019.1686793] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Background: Clinical decision-making within the physical therapy treatment process typically follows the hypothetical-deductive method. The accuracy and reliability of clinical tests affect this reasoning process. Musculoskeletal ultrasound imaging (MSK US) is an emerging valid and reliable diagnostic tool in physical therapy. MSK US allows for dynamic visualization of tissues in real time with devices that are often portable.Case Description: The patient was a 55-year-old female, who presented by direct access. She had been suffering from cervicogenic headaches since the age of 18. It was hypothesized that this patient presented with a right rotation positional default of atlas and facet hypomobility at C5-6.Outcomes: After six visits (over 7 weeks) of manual therapy interventions, the patient reported that her headaches and neck pain were no longer present. Her physical therapy goals had been met and she was discharged with the instruction to continue working on her posture correction and self-management.Discussion: This case report describes the use of MSK US imaging as part of the clinical decision-making process when treating a patient with cervicogenic headaches. This case illustrates the successful management using manual therapy to restore position, mobility, decrease muscle tone, and normalize upright posture. Complementary research is necessary to further validate MSK US imaging as the preferred method to objectivize joint mobility and guide decision-making. Additionally, the cause-effect relationship between the treatment and positive outcomes in this case report has to be further validated.
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Affiliation(s)
- Rob Sillevis
- Department of Rehabilitation Sciences, Florida Gulf Coast University, Fort Myers, FL, USA
| | - Kathy Swanick
- Department of Rehabilitation Sciences, Florida Gulf Coast University, Fort Myers, FL, USA
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Vargas CA, Baptista CAC, Del Sol M, Sandoval C, Vásquez B, Veuthey C, Ottone NE. Development of an ultrathin sheet plastination technique in rat humeral joints with osteoarthritis induced by monosodium iodoacetate for neovascularization study. Anat Sci Int 2019; 95:297-303. [PMID: 31401788 DOI: 10.1007/s12565-019-00500-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 08/05/2019] [Indexed: 11/27/2022]
Abstract
Injection with monosodium iodoacetate (MIA) is widely used to produce osteoarthritis (OA). Ultrathin sheet plastination has been used to study the morphology of structures, with strong application in anatomical education and research. Our aim was to carry out, for the first time, ultrathin sheet plastination of rat humeral joints to observe the neovascularization provoked by OA. We injected 0.1 mL of MIA into the left humeral joints of ten Sprague-Dawley rats. The right shoulders of the same rats were used as control. Sixteen weeks after the injection, the animals were euthanized and were given an immediate red epoxy resin injection through the thoracic aorta. The samples were fixed in 10% formalin, prior to the plastination process, without decalcification. Samples were dehydrated with acetone (100%) at - 25 °C, for 10 days. Later, for degreasing, samples were immersed in methylene chloride at room temperature during 1 week. Forced impregnation was performed inside a stove within a vacuum chamber. The plastinated blocks obtained were cut with a slow velocity diamond blade saw. Slices were placed in curing chambers to achieve curing and final tissue transparentation. 230 μm thickness slices were obtained. The slices were analyzed under magnifying glass and microscope, achieving visualization of OA neovascularization. The cartilage affected by OA loses its ability to remain avascular, and blood vessels invade it from the subchondral bone to the calcified and uncalcified cartilage. Ultra-thin sheet plastination is useful to observe articular cartilage neovascularization, caused by OA induced with MIA in humeral rat joint.
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Affiliation(s)
- Claudia Andrea Vargas
- Doctoral Program in Morphological Sciences, Medicine School, Universidad de La Frontera, Temuco, Chile
- Department of Physical Education, Sports and Recreation, Education School, Universidad de La Frontera, Temuco, Chile
| | - Carlos A C Baptista
- Laboratory of Plastination, Department of Medical Education, College of Medicine, University of Toledo, Toledo, OH, USA
| | - Mariano Del Sol
- Doctoral Program in Morphological Sciences, Medicine School, Universidad de La Frontera, Temuco, Chile
- Center of Excellence in Morphological and Surgical Studies (CEMyQ), Universidad de La Frontera, Temuco, Chile
| | - Cristian Sandoval
- Center of Excellence in Morphological and Surgical Studies (CEMyQ), Universidad de La Frontera, Temuco, Chile
| | - Bélgica Vásquez
- Facultad de Ciencias de la Salud, Universidad de Tarapacá, Arica, Chile
| | - Carlos Veuthey
- Laboratory of Plastination and Anatomical Techniques, Research Centre for Dental Sciences (CICO), Dental School, Universidad de La Frontera, Francisco Salazar 01145, Casilla 54-D, Temuco, Chile
| | - Nicolás Ernesto Ottone
- Doctoral Program in Morphological Sciences, Medicine School, Universidad de La Frontera, Temuco, Chile.
- Center of Excellence in Morphological and Surgical Studies (CEMyQ), Universidad de La Frontera, Temuco, Chile.
- Laboratory of Plastination and Anatomical Techniques, Research Centre for Dental Sciences (CICO), Dental School, Universidad de La Frontera, Francisco Salazar 01145, Casilla 54-D, Temuco, Chile.
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McElroy A, Rashmir A, Manfredi J, Sledge D, Carr E, Stopa E, Klinge P. Evaluation of the Structure of Myodural Bridges in an Equine Model of Ehlers-Danlos Syndromes. Sci Rep 2019; 9:9978. [PMID: 31292490 PMCID: PMC6620297 DOI: 10.1038/s41598-019-46444-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 06/25/2019] [Indexed: 11/28/2022] Open
Abstract
Myodural bridges have been described in various species as connective tissue structures “bridging” small cranio-cervical muscles to the dura. Myodural bridges are thought to stabilize the dural sac during head and neck movements and promote cerebrospinal fluid motion; however, their role in neurological diseases has not yet been established. We report ultrasonographic visualization, necropsy, histopathologic and ultrastructural findings of myodural bridges in horses with hereditary equine regional dermal asthenia (HERDA), an equine model of Ehlers-Danlos syndromes. Five HERDA and 5 control horses were studied. Post-mortem examination and ultrasonographic studies (3 HERDA and 4 controls) demonstrated that the atlanto-occipital and atlanto-axial myodural bridges are dynamic structures “moving” the dura. En block resection of the myodural bridges (4 HERDA and 5 controls) was accomplished and histopathology showed myofiber degeneration in 3 HERDA horses and 1 control. Ultrastructural examination revealed loosely packed collagen fibrils with abnormal orientation in all HERDA horses compared to mild abnormalities in 2 controls. Our study provides necropsy and ultrasonographic evidence of the dynamic aspect of the myodural bridges as dural sac stabilizers. Myodural bridges may be pathologically altered in connective tissue disease as evidenced by the ultrastructural morphology in the HERDA myodural bridge.
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Affiliation(s)
- Abigail McElroy
- Michigan State University College of Veterinary Medicine, Large Animal Clinical Sciences, East Lansing, MI, USA.
| | - Ann Rashmir
- Michigan State University College of Veterinary Medicine, Large Animal Clinical Sciences, East Lansing, MI, USA
| | - Jane Manfredi
- Michigan State University College of Veterinary Medicine, Pathobiology and Diagnostic Investigation, East Lansing, MI, USA
| | - Dodd Sledge
- Michigan State University Veterinary Diagnostic Laboratory, Lansing, MI, USA
| | - Elizabeth Carr
- Michigan State University College of Veterinary Medicine, Large Animal Clinical Sciences, East Lansing, MI, USA
| | - Edward Stopa
- Rhode Island Hospital, Departments of Pathology and Neurosurgery, Providence, RI, USA
| | - Petra Klinge
- Rhode Island Hospital, Department of Neurosurgery, Providence, RI, USA
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Kitamura K, Cho KH, Yamamoto M, Ishii M, Murakami G, Rodríguez-Vázquez JF, Abe SI. Suboccipital myodural bridges revisited: Application to cervicogenic headaches. Clin Anat 2019; 32:914-928. [PMID: 31116454 DOI: 10.1002/ca.23411] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 05/14/2019] [Accepted: 05/20/2019] [Indexed: 12/26/2022]
Abstract
There seems to be no complete demonstration of the suboccipital fascial configuration. In 30 human fetuses near term, we found two types of candidate myodural bridge: (1) a thick connective tissue band running between the rectus capitis posterior major and minor muscles (rectus capitis posterior major [Rma], rectus capitis posterior minori [Rmi]; Type 1 bridge; 27 fetuses); and (2) a thin fascia extending from the upper margin of the Rmi (Type 2 bridge; 20 fetuses). Neither of these bridge candidates contained elastic fibers. The Type 1 bridge originated from: (1) fatty tissue located beneath the semispinalis capitis (four fetuses); (2) a fascia covering the multifidus (nine); (3) a fascia bordering between the Rma and Rmi or lining the Rma (13); (4) a fascia covering the inferior aspect of the Rmi (three); and (5) a common fascia covering the Rma and obliquus capitis inferior muscle (nine). Multiple origins usually coexisted in the 27 fetuses. In the minor Type 2 bridge, composite fibers were aligned in the same direction as striated muscle fibers. Thus, force transmission via the thin fascia seemed to be effective along a straight line. However, in the major Type 1 bridges, striated muscle fibers almost always did not insert into or originate from the covering fascia. Moreover, at and near the dural attachment, most composite fibers of Type 1 bridges were interrupted by subdural veins and dispersed around the veins. In newborns, force transmission via myodural bridges was likely to be limited or ineffective. The postnatal growth might determine a likely connection between the bridge and headache. Clin. Anat. 32:914-928, 2019. © 2019 Wiley Periodicals, Inc.
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Affiliation(s)
- Kei Kitamura
- Department of Histology and Developmental Biology, Tokyo Dental College, Tokyo, Japan
| | - Kwang Ho Cho
- Department of Neurology, Wonkwang University School of Medicine and Hospital, Institute of Wonkwang Medical Science, Iksan, Jeonbuk, South Korea
| | | | | | - Gen Murakami
- Department of Anatomy, Tokyo Dental College, Tokyo, Japan.,Division of Internal Medicine, Jikoukai Home Visits Clinic, Sapporo, Japan
| | | | - Shin-Ichi Abe
- Department of Anatomy, Tokyo Dental College, Tokyo, Japan
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Kuć J, Szarejko KD, Aleksandrowicz K, Gołębiewska M. The role of soft tissue mobilization in reducing orofacial and general complaints in a patient with Kimmerle anomaly and temporomandibular joint disorder: A case report. Cranio 2019; 39:74-87. [DOI: 10.1080/08869634.2018.1560616] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Joanna Kuć
- Department of Prosthodontics, Medical University of Bialystok, Bialystok, Poland
| | | | - Krzysztof Aleksandrowicz
- Department of Health Care Sciences, History of Physical Medicine and Balneology, Medical University of Wroclaw, Wroclaw, Poland
| | - Maria Gołębiewska
- Department of Prosthodontics, Medical University of Bialystok, Bialystok, Poland
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Oosterbos C, Vanvolsem S, Duyvendak W, Donkersloot P, Wissels M, Put E, Roosen G, Plazier M. Retrograde Placement of High Cervical Electrodes: A Technical Refinement and Case Series. Neuromodulation 2018; 21:755-761. [DOI: 10.1111/ner.12770] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Revised: 01/09/2018] [Accepted: 01/31/2018] [Indexed: 11/28/2022]
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Okoye CS, Zheng N, Yu SB, Sui HJ. The myodural bridge in the common rock pigeon (Columbia livia): Morphology and possible physiological implications. J Morphol 2018; 279:1524-1531. [PMID: 30284324 DOI: 10.1002/jmor.20890] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 07/16/2018] [Accepted: 08/03/2018] [Indexed: 11/09/2022]
Abstract
The dense connective tissue that connects muscles to the cervical spinal dura mater is known as the myodural bridge in human anatomy and has been a subject of interest to anatomists and clinicians. The myodural bridge was originally discovered in humans, and also has been observed in other mammals and in reptilian sauropsids. We investigated the existence of the myodural bridge in a bird, that is, the Common Rock Pigeon Columba livia, to expand the understanding of the structure and function of the myodural bridge. Gross anatomical dissection of seven specimens and histological analyses of the suboccipital region of eight specimens were performed. The rectus capitis dorsalis minor muscle joins occipital periosteal extensions and inserts with several dense connective tissue cords on the dorsal side of the dura mater of the cervical spinal cord. The myodural bridge consists primarily of collagen Type I fibres, suggesting that the myodural bridge can transmit strong tensional forces generated by the contraction of M. rectus capitis dorsalis minor to the dura mater. The pull on the dura mater may affect the circulation of the cerebrospinal fluid in the subarachnoid space of the spine.
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Affiliation(s)
- Chukwuemeka Samuel Okoye
- Department of Anatomy, College of Basic Medicine, Dalian Medical University, Dalian, P. R. China
| | - Nan Zheng
- Department of Anatomy, College of Basic Medicine, Dalian Medical University, Dalian, P. R. China
| | - Sheng-Bo Yu
- Department of Anatomy, College of Basic Medicine, Dalian Medical University, Dalian, P. R. China
| | - Hong-Jin Sui
- Department of Anatomy, College of Basic Medicine, Dalian Medical University, Dalian, P. R. China
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Zheng N, Chi YY, Yang XH, Wang NX, Li YL, Ge YY, Zhang LX, Liu TY, Yuan XY, Yu SB, Sui HJ. Orientation and property of fibers of the myodural bridge in humans. Spine J 2018; 18:1081-7. [PMID: 29477753 DOI: 10.1016/j.spinee.2018.02.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Revised: 01/24/2018] [Accepted: 02/01/2018] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Studies over the past 20 years have revealed that there are fibrous connective tissues between the suboccipital muscles, nuchal ligament, and cervical spinal dura mater (SDM). This fibrous connection with the SDM is through the posterior atlanto-occipital or atlantoaxial interspaces and is called the myodural bridge (MDB). Researchers have inferred that the MDB might have important functions. It was speculated that the function of MDB might be related to proprioception transmission, keeping the subarachnoid space and the cerebellomedullary cistern unobstructed, and affecting the dynamic circulation of the cerebrospinal fluid. In addition, clinicians have found that the pathologic change of the MDB might cause cervicogenic or chronic tension-type headache. Previous gross anatomical and histologic studies only confirmed the existence of the MDB but did not reveal the fiber properties of the MDB. This is important to further mechanical and functional research on the MDB. PURPOSE Multiple histologic staining methods were used in the present study to reveal the various origin and fiber properties of the MDB. Muscles and ligaments participating in forming the MDB at the posterior atlanto-occipital or atlantoaxial interspaces were observed, and the fiber properties of the MDB were confirmed. The present study provides a basis for speculating the tensile force values of the MDB on the SDM and a morphologic foundational work for exploring the physiological functions and clinical significances of the MDB. STUDY DESIGN Anatomical and histologic analyses of suboccipital structures that communicate with the SDM at the posterior atlanto-occipital or atlantoaxial interspaces were carried out. METHODS Multiple histologic staining methods were used to evaluate the histologic properties and composition of the MDB at the posterior atlanto-occipital or atlantoaxial interspaces in five formalin-fixed head-neck human specimens. RESULTS The results show that the MDB traversing the atlanto-occipital interspace originated from the rectus capitis posterior minor (RCPmi). The MDB traversing the atlantoaxial interspace originated mainly from the RCPmi, rectus capitis posterior major, and obliquus capitis inferior. These fibers form the vertebral dural ligament in the atlantoaxial interspace and connect with SDM. The MDB is mainly formed by parallel running type I collagen fibers; thus, suboccipital muscle could pull SDM strongly through the effective force propagated by the MDB during head movement. CONCLUSIONS Myodural bridge is mainly formed by parallel running type I collagen fibers; thus, it can transmit the strong pull from the diverse suboccipital muscles or ligaments during head movement. The results of the present study will serve as a basis for further biomechanical and functional MDB research.
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Ottone NE, Baptista CAC, Latorre R, Bianchi HF, Del Sol M, Fuentes R. E12 sheet plastination: Techniques and applications. Clin Anat 2017; 31:742-756. [DOI: 10.1002/ca.23008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Revised: 10/10/2017] [Accepted: 10/25/2017] [Indexed: 11/07/2022]
Affiliation(s)
- Nicolas Ernesto Ottone
- Laboratory of Plastination & Anatomical Techniques, CICO Research Centre of Dental Sciences, Adults Integral Dentistry Department, Dental School; Universidad de la Frontera; Temuco Chile
- Doctoral Program in Morphological Sciences, Faculty of Medicine; Universidad de La Frontera; Temuco Chile
| | - Carlos A. C. Baptista
- Laboratory of Plastination, Department of Medical Education; College of Medicine, University of Toledo; Toledo Ohio
| | - Rafael Latorre
- Department of Anatomy and Compared Pathological Anatomy; Campus Mare Nostrum, University of Murcia; Spain
| | - Homero Felipe Bianchi
- Anatomy Department; School of Medicine, University of Buenos Aires; Buenos Aires Argentina
- Anatomy Department; IUCS Barcelo Foundation; Buenos Aires Argentina
| | - Mariano Del Sol
- Doctoral Program in Morphological Sciences, Faculty of Medicine; Universidad de La Frontera; Temuco Chile
- Center of Excellence in Morphological and Surgical Studies (CEMyQ); Faculty of Medicine, Universidad de La Frontera; Chile
| | - Ramon Fuentes
- Laboratory of Plastination & Anatomical Techniques, CICO Research Centre of Dental Sciences, Adults Integral Dentistry Department, Dental School; Universidad de la Frontera; Temuco Chile
- Doctoral Program in Morphological Sciences, Faculty of Medicine; Universidad de La Frontera; Temuco Chile
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Zheng N, Yuan XY, Chi YY, Liu P, Wang B, Sui JY, Han SH, Yu SB, Sui HJ. The universal existence of myodural bridge in mammals: an indication of a necessary function. Sci Rep 2017; 7:8248. [PMID: 28811472 PMCID: PMC5557938 DOI: 10.1038/s41598-017-06863-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Accepted: 06/20/2017] [Indexed: 11/09/2022] Open
Abstract
The “myodural bridge” was described in literatures as a dense fibrous tissue connecting the sub-occipital musculature with the spinal dura mater in human studies. Now the concept of “myodural bridge” was perceived as an exact anatomical structure presumably essential for critical physiological functions in human body, and might exist in other mammals as well. To determine the existence of the “myodural bridge” in other mammals and to lay a foundation for the functional study, we examined representatives in five different mammalian orders. Based on the anatomical dissections, P45 plastinated sections and histological sections, we found that a dense fibrous tissue connected the rectus capitisdorsalis minor and the spinal dura mater through the dorsal atlanto-occipital interspace with or without the medium of the posterior atlanto-occipital membrane. These observed connective tissues were very similar to the “myodural bridge” previously described in humans. We proposed that the “myodural bridge”, as an evolutionally conserved structure, presents in many other mammals. Moreover, we believed that the “myodural bridge” might be a homologous organ in mammals. Thus, this study could provide an insight for our understanding the physiological significance of the “myodural bridge”, especially in human.
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Affiliation(s)
- Nan Zheng
- Department of Anatomy, College of Basic Medicine, Dalian Medical University, Dalian, P.R. China
| | - Xiao-Ying Yuan
- Department of Anatomy, College of Basic Medicine, Dalian Medical University, Dalian, P.R. China
| | - Yan-Yan Chi
- Department of Anatomy, College of Basic Medicine, Dalian Medical University, Dalian, P.R. China
| | - Pei Liu
- Department of Anatomy, College of Basic Medicine, Dalian Medical University, Dalian, P.R. China
| | - Bing Wang
- Department of Anatomy, College of Basic Medicine, Dalian Medical University, Dalian, P.R. China
| | - Jia-Ying Sui
- Department of Anatomy, College of Basic Medicine, Dalian Medical University, Dalian, P.R. China
| | - Seung-Ho Han
- Department of Anatomy, College of Medicine, Chung-Ang University, Seoul, Korea
| | - Sheng-Bo Yu
- Department of Anatomy, College of Basic Medicine, Dalian Medical University, Dalian, P.R. China.
| | - Hong-Jin Sui
- Department of Anatomy, College of Basic Medicine, Dalian Medical University, Dalian, P.R. China. .,Dalian Hoffen Preservation Technique Institution, Dalian, P.R. China.
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Palomeque-Del-Cerro L, Arráez-Aybar LA, Rodríguez-Blanco C, Guzmán-García R, Menendez-Aparicio M, Oliva-Pascual-Vaca Á. A Systematic Review of the Soft-Tissue Connections Between Neck Muscles and Dura Mater: The Myodural Bridge. Spine (Phila Pa 1976) 2017; 42:49-54. [PMID: 27116115 DOI: 10.1097/BRS.0000000000001655] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Systematic review. OBJECTIVE To elucidate the existence of soft tissue connections between the neck muscles and cervical dura mater. SUMMARY OF BACKGROUND DATA Several studies discuss the existence of a cervical myodural bridge; however, conflicting data have been reported. METHODS Searches were conducted in the PubMed, Web of Science, Cochrane Library, and PEDro databases. Studies reporting original data regarding the continuity of non-post-surgical soft tissue between the cervical muscles and dura mater were reviewed. Two reviewers independently selected articles, and a third one resolved disagreements. Another two researchers extracted the methodology of the study, the anatomical findings, and evaluated the quality of the studies using Quality Appraisal for Cadaveric Studies Scale. A different third researcher resolved disagreements. RESULTS Twenty-six studies were included. A soft tissue connection between the rectus capitis posterior minor, the rectus capitis posterior major, and the obliquus capitis inferior muscles seems to be proved with a strong level of evidence for each one of them. Controversy exists about the possible communication between the dura mater and the upper trapezius, rhomboideus minor, serratus posterior superior, and splenius capitis by means of the ligamentum nuchae. Finally, there is limited evidence about the existence of a soft tissue connection between rectus capitis anterior muscle and the dura mater. CONCLUSION There is a continuity of soft tissue between the cervical musculature and the cervical dura mater; this might have physiological, pathophysiological, and therapeutic implications, and going some way to explaining the effect of some therapies in craniocervical disorders. LEVEL OF EVIDENCE N/A.
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