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Indexed by:期刊论文

Date of Publication:2021-03-05

Journal:SPINE

Volume:45

Issue:20

Page Number:E1296-E1301

ISSN No.:0362-2436

Key Words:cerebrospinal fluid leakage; myodural bridge; scanning electron microscope; spinal dura mater; upper neck surgery

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.