Skip to main content
SpringerLink
Log in

The myodural bridge complex defined as a new functional structure

  • Original Article
  • Published:
Surgical and Radiologic Anatomy Aims and scope Submit manuscript

Abstract

Purpose

The connective tissue between suboccipital muscles and the cervical spinal dura mater (SDM) is known as the myodural bridge (MDB). However, the adjacent relationship of the different connective tissue fibers that form the MDB remains unclear. This information will be highly useful in exploring the function of the MDB.

Methods

The adjacent relationship of different connective tissue fibers of MDB was demonstrated based upon three-dimensional visualization model, P45 plastinated slices and histological sections of human MDB.

Results

We found that the MDB originating from the rectus capitis posterior minor muscle (RCPmi), rectus capitis posterior major muscle (RCPma) and obliquus capitis inferior muscle (OCI) in the suboccipital region coexists. Part of the MDB fibers originate from the ventral aspect of the RCPmi and, together with that from the cranial segment of the RCPma, pass through the posterior atlanto-occipital interspace (PAOiS) and enter into the posterior aspect of the upper cervical SDM. Also, part of the MDB fibers originate from the dorsal aspect of the RCPmi, the ventral aspect of the caudal segment of the RCPma, and the ventral aspect of the medial segment of the OCI, enter the central part of the posterior atlanto-axial interspace (PAAiS) and fuse with the vertebral dura ligament (VDL), which connects with the cervical SDM.

Conclusions

Our findings prove that the MDB exists as a complex structure which we termed the ‘myodural bridge complex’ (MDBC). In the process of head movement, tensile forces could be transferred possibly and effectively by means of the MDBC. The concept of MDBC will be beneficial in the overall exploration of the function of the MDB.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 9

Similar content being viewed by others

References

  1. Dean NA, Mitchell BS (2002) Anatomic relation between the nuchal ligament (ligamentum nuchae) and the spinal dura mater in the craniocervical region. Clin Anat 15:182–185

    Article  CAS  Google Scholar 

  2. Fernández-de-las-Penas C, Cuadrado ML, Arendt-Nielsen L et al (2008) Association of cross-sectional area of the rectus capitis posterior minor muscle with active trigger points in chronic tension-type headache: a pilot study. Am J Phys Med Rehab 87(3):197–203

    Article  Google Scholar 

  3. Grgić V (2007) Cervicogenic headache: etiopathogenesis, characteristics, diagnosis, differential diagnosis and therapy. Lijec Vjesn 129(6–7):230–236

    PubMed  Google Scholar 

  4. Gao HB, Liu J, Yu SB, Su HJ (2006) A new polyester technique for sheet plastination. J Int Soc Plast 21:7–11

    Google Scholar 

  5. Hack GD, Koritzer RT, Robinson WL et al (1995) Anatomic relation between the rectus capitis posterior minor muscle and the dura mater. Spine 20:2484–2486

    Article  CAS  Google Scholar 

  6. Humphreys BK, Kenin S, Hubbard BB et al (2003) Investigation of connective tissue attachments to the cervical spinal dura mater. Clin Anat 16:152–159

    Article  CAS  Google Scholar 

  7. Kulkarni V, Chandy MJ, Babu KS (2001) Quantitative study of muscle spindles in suboccipital muscles of human fetuses. Neurol India 49(4):355–359

    CAS  PubMed  Google Scholar 

  8. Kahkeshani K, Ward PJ (2012) Connection between the spinal dura mater and suboccipital musculature: evidence for the myodural bridge and a route for its dissection–a review. Clin Anat 25(4):415–422

    Article  Google Scholar 

  9. Mitchell BS, Humphreys BK, O’Sullivan E (1998) Attachments of the ligamentum nuchae to cervical posterior spinal dura and the lateral part of the occipital bone. J Manip Physiol Ther 21:145–148

    CAS  Google Scholar 

  10. Matthew EA, Deanna KB (1999) A proposed etiology of cervicogenic headache: the neurophysiologic basis and anatomic relationship between the dura mater and the rectus posterior capitis minor muscle. J Manip Physiol Ther 22:534–539

    Article  Google Scholar 

  11. Pontell ME, Scali F, Enix DE et al (2013) Histological examination of the human obliquus capitis inferior myodural bridge. Ann Anat 195(6):522–526

    Article  Google Scholar 

  12. Pontell ME, Scali F, Marshall E et al (2013) The obliquus capitis inferior myodural bridge. Clin Anat 26:450–454

    Article  Google Scholar 

  13. Peck D, Buxton DF, Nitz A (1984) A comparison of spindle concentrations in large and small muscles acting in parallel combinations. J Morphol 180(3):243–252

    Article  CAS  Google Scholar 

  14. Park JS, Chung MS, Shin DS et al (2009) Sectioned images of the cadaver head including the brain and correspondences with ultrahigh field 7.0 T MRIs. Proc IEEE 97(12):1988–1996

    Article  Google Scholar 

  15. Rix GD, Bagust J (2001) Cervicocephalic kinesthetic sensibility in patients with chronic, nontraumatic cervical spine pain. Arch Phys Med Rehabil 82(7):911–919

    Article  CAS  Google Scholar 

  16. Scali F, Marsili ES, Pontell ME et al (2011) Anatomical connection between the rectus capitis posterior major and the dura mater. Spine 36(25):E1612–E1614

    Article  Google Scholar 

  17. Scali F, Pontell ME, Enix DE (2013) Histological analysis of the rectus capitis posterior major’s myodural bridge. Spine J 13:558–563

    Article  Google Scholar 

  18. Sui HJ, Henry RW (2007) Polyester plastination of biological tissue: hoffen P45 technique. J Int Soc Plast 22:78–81

    Google Scholar 

  19. Xu Q, Yu SB, Zheng N et al (2015) Head movement, an important contributor to human cerebrospinal fluid circulation. Sci Rep 19(6):31787

    Google Scholar 

  20. Yuan XY, Yu SB, Liu C et al (2017) Correlation between chronic headaches and the rectus capitis posterior minor muscle: a comparative analysis of cross-sectional trail. Cephalalgia 37(11):1051–1056

    Article  Google Scholar 

  21. Zheng N, Yuan XY, Chi YY et al (2017) The universal existence of myodural bridge in mammals: an indication of a necessary function. Sci Rep 7:8248

    Article  Google Scholar 

  22. Zheng N, Yuan XY, Li YF et al (2014) Definition of the to be named ligament and vertebrodural ligament and their possible effects on the circulation of CSF. PLoS One 9(8):e103451

    Article  Google Scholar 

  23. Zheng N, Chi YY, Yang XH et al (2018) Orientation and property of fibers of the myodural bridge in humans. Spine J 18(6):1081–1087

    Article  Google Scholar 

Download references

Acknowledgments

The authors thank Min Suk Chung for his wonderful suggestions in designing the present study. The authors also gratefully acknowledge those who donated their bodies and their families. This study was supported Natural Science Foundation of China (NSFC31571234) awarded to Hong-Jin Sui(Joy: PI) and Natural Science Foundation of China (NSFC31600972) awarded to Nan Zheng(Joy: PI).

Author information

Author notes

  1. Hong-Jin Sui and Sheng-Bo Yu contributed equally to this work.

  2. Nan Zheng and Beom Sun Chung contributed equally to this work.

Authors and Affiliations

  1. Department of Anatomy, College of Basic Medicine, Dalian Medical University, 9 West Section, Lushun South Road, Dalian, People’s Republic of China

    Nan Zheng, Yi-Lin Li, Tai-Yuan Liu, Lan-Xin Zhang, Yang-Yang Ge, Nan-Xing Wang, Zhi-Hong Zhang, Lin Cai, Yan-Yan Chi, Jian-Fei Zhang, Okoye Chukwuemeka Samuel, Sheng-Bo Yu & Hong-Jin Sui

  2. Department of Anatomy, Ajou University School of Medicine, Worldcup-ro 164, Suwon, 443-749, Republic of Korea

    Beom Sun Chung

Authors
  1. Nan Zheng
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Beom Sun Chung
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yi-Lin Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Tai-Yuan Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Lan-Xin Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Yang-Yang Ge
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Nan-Xing Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Zhi-Hong Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Lin Cai
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Yan-Yan Chi
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Jian-Fei Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Okoye Chukwuemeka Samuel
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Sheng-Bo Yu
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Hong-Jin Sui
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

SB Yu and HJ Sui: Project development. N Zheng, YL Li, TY Liu, LX Zhang, YY Ge, NX Wang, ZH Zhang and L Cai: Data collection and analysis. YY Chi, JF Zhang: Data analysis N Zheng and BS Chung: Manuscript writing. SB Yu, HJ Sui, OC Samuel and MS Chung: Manuscript editing.

Corresponding authors

Correspondence to Sheng-Bo Yu or Hong-Jin Sui.

Ethics declarations

Conflict of interest

The authors declare no conflicts of interest associated with this study.

Ethical approval

All the procedures performed in this study which involvs human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Zheng, N., Chung, B.S., Li, YL. et al. The myodural bridge complex defined as a new functional structure. Surg Radiol Anat 42, 143–153 (2020). https://doi.org/10.1007/s00276-019-02340-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00276-019-02340-6

Keywords

Search

Navigation