Scanning Electron Microscopic Observation of Myodural Bridge in the Human Suboccipital Region

Abstract

Study Design. A scanning electron microscopic study performed on three cadaveric specimens focused on the human suboccipital region, specifically, myodural bridge (MDB). Objective. This study showed the connection form of the MDB among the suboccipital muscles, the posterior atlanto-occipital membrane (PAOM) and the spinal dura mater (SDM), and provided an ultrastructural morphological basis for the functional studies of the MDB. Summary of Background Data. Since the myodural bridge was first discovered by Hack, researches on its morphology and functions had been progressing continuously. However, at present, research results about MDB were still limited to the gross anatomical and histological level. There was no research report showing the MDB's ultrastructural morphology and its ultrastructural connection forms between PAOM and SDM. Methods. A scanning electron microscope (SEM) was used to observe the connection of myodural bridge fibers with PAOM and SDM in atlanto-occipital and atlanto-axial interspaces, and the connection forms were analyzed. Results. Under the SEM, it was observed that there were clear direct connections between the suboccipital muscles and the PAOM and SDM in the atlanto-occipital and atlanto-axial spaces. These connections were myodural bridge. The fibers of the myodural bridge merged into the spinal dura mater and gradually became a superficial layer of the spinal dura mater. Conclusion. MDB fibers merged into the SDM and became part of the SDM in the atlanto-occipital and atlanto-axial space. MDB could transfer tension and pulling force to the SDM effectively, during the contraction or relaxation of the suboccipital muscles. Level of Evidence: N/A

A new concept of the fiber composition of cervical spinal dura mater: an investigation utilizing the P45 sheet plastination technique

“…In previous studies [14,28], scanning electron microscopy (SEM) and histological investigations observed that some of the MDB fibers originated from the ventral part of the RCPmi muscle. These fibers passed through the atlanto-occipital interspace and gradually merged into the SDM forming the superficial layer of the SDM.…”

“…At present, the surgical treatment of CM primarily involves bone decompression, duraplasty, the resection of the tonsils of the cerebellum, and other methods [4,11,12,22,31]. These cervical surgical procedures often result in postoperative complications such as cerebrospinal fluid leakage, pseudomeningocele, hemorrhage, and reduced dural tension, due to occipital periosteum dissection, MDB removion, and improper dural dissection [9,14,18,19,24]. Therefore, we propose that during surgery, attention should be paid to the protection of the three sources of fibers of composing the spinal dura mater.…”

Suggesting a mechanism for acupuncture as a global percutaneous needle fasciotomy that respects tensegrity principles for treating fibromyalgia

“…The material surrounding blood vessels and lymphatics includes interstitial connective tissue (31). The myodural bridge connects the rectus capitis posterior with the dura (133,134) and there is evidence that the meninges and the brain function as one network (135)(136)(137)(138). Modulating interstitial connective tissue would cause biomechanical, vasomotor and neuromodulatory effects (31).…”

The growth and developmental of the myodural bridge and its associated structures in the human fetus

“…Zheng et al proposed that the MDB originating from the suboccipital muscles formed a functional unit that they termed the 'Myodural Bridge Complex' (MDBC) 12 . Jiang et al described the ultra-microstructure of the human MDB via scanning electron microscopy 13 .…”