Tuesday, January 13, 2009

Know why many people complain lower extremity symptoms when CPA to cervical spine is administered

Discovery of Dural Attachments in the Cervical Spine:

The cervical spine is stabilized posteriorly by the ligamentum nuchae and other ligaments. While previous research has described the ligamentum nuchae in general terms. A study (byMitchell BS, Humphreys BK, O'Sullivan E) attempted to describe more detailed attachments to the cervical posterior spinal dura and to posterolateral parts of the occipital bone.
10 cadavers were sectioned to reveal the ligamentum nuchae and its connection to the cervical posterior spinal dura, allowing for particular attention and reference to the deep aspects of the suboccipital triangle and upper cervical region.
In the midline between the first and second cervical vertebrae, researchers found a fibroelastic ligamentous attachment to the cervical posterior spinal dura derived from the ligamentum nuchae. As the ligamentum passed cranially, part of it passed bilaterally to the posterior aspect of the base of the occipital bone, as far superiorly as the inferior nuchal line and as far laterally as the sutures with the temporal bones.This study reveals a more complex morphology of the ligamentum nuchae than has previously been described. The bilateral attachments of the nuchae to the occipital bone reaffirm its role in stabilizing the head during rotation of the cervical spine.
These findings may have implications in the understanding of facial and cervical pain and associated disorders.
Reference:
Attachments of the ligamentum nuchae to cervical posterior spinal dura and the lateral part of the occipital bone. Journal of Manipulative and Physiological Therapeutics, March/April 1998;21(3), pp145-48.

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