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Kim DH, Hong JT, Hur JW, Kim IS, Lee HJ, Lee JB. Clinical and Radiological Outcomes in C2 Recapping Laminoplasty for the Pathologies in the Upper Cervical Spine. Neurospine 2024; 21:565-574. [PMID: 38955529 PMCID: PMC11224761 DOI: 10.14245/ns.2347270.635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 01/31/2024] [Accepted: 02/09/2024] [Indexed: 07/04/2024] Open
Abstract
OBJECTIVE To evaluate C2 muscle preservation effect and the radiological and clinical outcomes after C2 recapping laminoplasty. METHODS Fourteen consecutive patients who underwent C2 recapping laminoplasty around C1-2 level were enrolled. To evaluate muscle preservation effect, the authors conducted a morphological measurement of extensor muscles between the operated and nonoperated side. Two surgeons measured the cross-sectional area (CSA) of obliquus capitis inferior (OCI) and semispinalis cervicis (SSC) muscle before and after surgery to determine atrophy rates (ARs). Additionally, we examined range of motion (ROM), sagittal vertical axis (SVA), neck visual analogue scale (VAS), Neck Disability Index (NDI), and Japanese Orthopaedic Association (JOA) score to assess potential changes in alignment and consequent clinical outcomes following posterior cervical surgery. RESULTS We measured the CSA of OCI and SSC before surgery, and at 6 and 12 months postoperatively. Based on these measurements, the AR of the nonoperated SSC was 0.1% ± 8.5%, the AR of the operated OCI was 2.0% ± 7.2%, and the AR of the nonoperated OCI was -0.7% ± 5.1% at the 12 months after surgery. However, the AR of the operated side's SSC was 11.2% ± 12.5%, which is a relatively higher value than other measurements. Despite the atrophic change of SSC on the operated side, there were no prominent changes observed in SVA, C0-2 ROM, and C2-7 ROM between preoperative and 12 months postoperative measurements, which were 11.8 ± 10.9 mm, 16.3° ± 5.9°, and 48.7° ± 7.7° preoperatively, and 14.1 ± 11.6 mm, 16.1° ± 7.2°, and 44.0° ± 10.3° at 12 months postoperative, respectively. Improvement was also noted in VAS, NDI, and JOA scores after surgery with JOA recovery rate of 77.3% ± 29.6%. CONCLUSION C2 recapping laminoplasty could be a useful tool for addressing pathologies around the upper cervical spine, potentially mitigating muscle atrophy and reducing postoperative neck pain, while maintaining sagittal alignment and ROM.
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Affiliation(s)
- Dong Hun Kim
- Department of Neurosurgery, Eunpyeong St. Mary’s Hospital, The Catholic University of Korea, Seoul, Korea
| | - Jae Taek Hong
- Department of Neurosurgery, Eunpyeong St. Mary’s Hospital, The Catholic University of Korea, Seoul, Korea
| | - Jung Woo Hur
- Department of Neurosurgery, Eunpyeong St. Mary’s Hospital, The Catholic University of Korea, Seoul, Korea
| | - Il Sup Kim
- Department of Neurosurgery, St. Vincent Hospital, The Catholic University of Korea, Suwon, Korea
| | - Ho Jin Lee
- Department of Neurosurgery, St. Vincent Hospital, The Catholic University of Korea, Suwon, Korea
| | - Jong Beom Lee
- Department of Neurosurgery, Chungbuk National University Hospital, Cheongju, Korea
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Suboccipital Muscles, Forward Head Posture, and Cervicogenic Dizziness. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58121791. [PMID: 36556992 PMCID: PMC9786116 DOI: 10.3390/medicina58121791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 11/08/2022] [Accepted: 12/01/2022] [Indexed: 12/12/2022]
Abstract
Dizziness or vertigo can be caused by dysfunction of the vestibular or non-vestibular systems. The diagnosis, treatment, and mechanism of dizziness or vertigo caused by vestibular dysfunction have been described in detail. However, dizziness by the non-vestibular system, especially cervicogenic dizziness, is not well known. This paper explained the cervicogenic dizziness caused by abnormal sensory input with references to several studies. Among head and neck muscles, suboccipital muscles act as stabilizers and controllers of the head. Structural and functional changes of the suboccipital muscles can induce dizziness. Especially, myodural bridges and activation of trigger point stimulated by abnormal head posture may be associated with cervicogenic dizziness.
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Li C, Yue C, Liu ZC, Gong J, Wei XS, Yang H, Gilmore C, Yu SB, Hack GD, Sui HJ. The relationship between myodural bridges, hyperplasia of the suboccipital musculature, and intracranial pressure. PLoS One 2022; 17:e0273193. [PMID: 36054096 PMCID: PMC9439232 DOI: 10.1371/journal.pone.0273193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 08/04/2022] [Indexed: 11/23/2022] Open
Abstract
During mammalian evolution, the Myodural Bridges (MDB) have been shown to be highly conserved anatomical structures. However, the putative physiological function of these structures remains unclear. The MDB functionally connects the suboccipital musculature to the cervical spinal dura mater, while passing through the posterior atlanto-occipital and atlanto-axial interspaces. MDB transmits the tensile forces generated by the suboccipital muscles to the cervical dura mater. Moreover, head movements have been shown to be an important contributor to human CSF circulation. In the present study, a 16-week administration of a Myostatin-specific inhibitor, ACE-031, was injected into the suboccipital musculature of rats to establish an experimental animal model of hyperplasia of the suboccipital musculature. Using an optic fiber pressure measurement instrument, the present authors observed a significant increase in intracranial pressure (ICP) while utilizing the hyperplasia model. In contrast, surgically severing the MDB connections resulted in a significant decrease in intracranial pressure. Thus, these results indicated that muscular activation of the MDB may affect CSF circulation, suggesting a potential functional role of the MDB, and providing a new research perspective on CSF dynamics.
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Affiliation(s)
- Chan Li
- Department of Anatomy, Dalian Medical University, Dalian, China
| | - Chen Yue
- Department of Gynecology and Obstetrics, The Second Hospital of Dalian Medical University, Dalian, China
| | - Zhao-Chang Liu
- Department of Anatomy, Dalian Medical University, Dalian, China
| | - Jin Gong
- Department of Anatomy, Dalian Medical University, Dalian, China
| | - Xiao-Song Wei
- Department of Anatomy, Dalian Medical University, Dalian, China
| | - Heng Yang
- Department of Anatomy, Dalian Medical University, Dalian, China
| | - Campbell Gilmore
- Medical School, St. George’s University of London, London, United Kingdom
| | - Sheng-Bo Yu
- Department of Anatomy, Dalian Medical University, Dalian, China
| | - Gary D. Hack
- Department of Advanced Oral Sciences and Therapeutics, University of Maryland, Baltimore, Maryland, United States of America
- * E-mail: (HJS); (GDH)
| | - Hong-Jin Sui
- Department of Anatomy, Dalian Medical University, Dalian, China
- * E-mail: (HJS); (GDH)
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Abstract
Working on the diaphragm muscle and the connected diaphragms is part of the respiratory-circulatory osteopathic model. The breath allows the free movement of body fluids and according to the concept of this model, the patient's health is preserved thanks to the cleaning of the tissues by means of the movement of the fluids (blood, lymph). The respiratory muscle has several systemic connections and multiple functions. The founder of osteopathic medicine emphasized the importance of the thoracic diaphragm and body health. The five diaphragms (tentorium cerebelli, tongue, thoracic outlet, thoracic diaphragm and pelvic floor) represent an important tool for the osteopath to evaluate and find a treatment strategy with the ultimate goal of patient well-being. The two articles highlight the most up-to-date scientific information on the myofascial continuum for the first time. Knowledge of myofascial connections is the basis for understanding the importance of the five diaphragms in osteopathic medicine. In this first part, the article reviews the systemic myofascial posterolateral relationships of the respiratory diaphragm; in the second I will deal with the myofascial anterolateral myofascial connections.
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Affiliation(s)
- Bruno Bordoni
- Physical Medicine and Rehabilitation, Foundation Don Carlo Gnocchi, Milan, ITA
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Sun MY, Han X, Wang MY, Ning DX, Xu B, Xie LZ, Yu SB, Sui HJ. Relationship between the sectional area of the rectus capitis posterior minor and the to be named ligament from 3D MR imaging. BMC Musculoskelet Disord 2020; 21:101. [PMID: 32059665 PMCID: PMC7023802 DOI: 10.1186/s12891-020-3123-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Accepted: 02/10/2020] [Indexed: 11/18/2022] Open
Abstract
Background To evaluate the maximal sectional area (SA) of the rectus capitis posterior minor (RCPmi) muscle and its potential correlation with to be named ligament (TBNL) in the suboccipital area using 3D MR imaging. Methods A total of 365 subjects underwent sagittal 3D T2WI MR imaging of the RCPmi and TBNL. Among them, 45 subjects were excluded due to a particular clinical history or poor image quality. Finally, 320 subjects met the inclusion criteria, including 138 men and 182 women. The 624 RCPmi muscles were classified into positive and negative groups according to their attachment to the TBNL. Two experienced radiologists manually measured the maximum SA of the RCPmi muscle on the parasagittal image with a 30° deviation from the median sagittal plane. The correlations between the SA and the subject’s age, height, BMI, gender, handedness, and age-related disc degeneration were tested by Spearman analysis. The SA differences between different groups were compared using independent samples t-test. Results A total of 123 RCPmi-TBNL attachments were identified in the positive group, while 501 RCPmi muscles were identified in the negative group. The SA of the 624 RCPmi muscles was 62.71 ± 28.72 mm2 and was poorly correlated with the subject’s age, BMI, or handedness, with no correlation with age-related disc degeneration. A fair correlation was found between the SA and the body height in the whole group, and poor correlation in each male/female group. The SA of the RCPmi muscle in males was significantly bigger than that in women ([75.54 ± 29.17] vs. [52.74 ± 24.07] mm2). The SA of RCPmi muscle in the positive group was significantly smaller than that in the negative group ([55.95 ± 26.76] mm2 vs. [64.37 ± 28.97] mm2). Conclusions Our results revealed a significantly smaller SA of the RCPmi in subjects with RCPmi-TBNL attachment. Besides, a larger SA of the RCPmi was correlated with the male gender. These findings suggest that the SA of the RCPmi ought to be interpreted with care for each patient since there could be considerable variations.
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Affiliation(s)
- Mei-Yu Sun
- Department of radiology, the first affiliated hospital of Dalian Medical University, Dalian, China
| | - Xu Han
- Department of radiology, the first affiliated hospital of Dalian Medical University, Dalian, China
| | - Meng-Yao Wang
- Department of radiology, the first affiliated hospital of Dalian Medical University, Dalian, China
| | - Dian-Xiu Ning
- Department of radiology, the first affiliated hospital of Dalian Medical University, Dalian, China
| | - Bin Xu
- Department of radiology, the first affiliated hospital of Dalian Medical University, Dalian, China
| | | | - Sheng-Bo Yu
- Department of Anatomy, College of Basic Medicine, Dalian Medical University, Dalian, 116044, People's Republic of China
| | - Hong-Jin Sui
- Department of Anatomy, College of Basic Medicine, Dalian Medical University, Dalian, 116044, People's Republic of China.
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Sun MY, Sui HJ, Eteer K, Yu SB, Hu JN. Utilization of MR imaging in myodural bridge complex with relevant muscles: current status and future perspectives. JOURNAL OF MUSCULOSKELETAL & NEURONAL INTERACTIONS 2020; 20:382-389. [PMID: 32877974 PMCID: PMC7493449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The aim of this study is to review and discuss the literature on the utilization of magnetic resonance imaging (MRI) in investigating the structure and feasible function of the myodural bridge complex (MDBC) with relevant muscles, which will be useful to understand the function of the MDB. The myodural bridge (MDB) is a soft tissue connective bridge that provides a fascial continuity between the musculature/ligament and cervical spinal dura mater (SDM) in the suboccipital areas. All of these involved structures are referred to as the MDBC. It would transfer tensile forces effectively from involved suboccipital muscles/ligament to SDM during head movement. Despite present achievements, its anatomic and functional role is still unclear. MRI enables not only in vivo visualization of ligaments, musculature and spinal dura with conventional T1W, T2W and PDW imaging, but also functional evaluation of MDBC with relevant muscles, such as muscles' fatty infiltration, cross-sectional area changes and injuries. Though some functional MRI techniques have not been used for the MDBC with relevant muscles now, these techniques have great potential to better understand function of MDBC including its suspected clinical role. MRI is likely the most powerful tool to study MDBC and relevant muscles with only limited exploration so far.
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Affiliation(s)
- Mei-Yu Sun
- The First Affiliated Hospital of Dalian Medical University, Department of Radiology, Dalian, P.R. China
| | - Hong-Jin Sui
- 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
| | - Jia-Ni Hu
- Department of Radiology, Wayne State University, USA
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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] [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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