Understanding Soft Tissue Connection Between Neck Muscles and Dura Mater Can Help Address Craniocervical Pain

A review ¹ in the journal Spine decided to look at a particular soft tissue connection. The said connection has been stated to exist between the dura mater and neck muscles. The evidence offered by this review could help bring froth better treatment for craniocervical pain in humans as well as ensure spinal health.

What Was the Purpose of this Review?

According to data, craniocervical pain has been recorded to have a high prevalence. It’s accompanied by a lot of physical, emotional, and socioeconomic effects. However, you should know that the pathophysiology of numerous disorders that involve craniocervical pain needs to be further explored. Diagnosing a patient experiencing such pain can be quite a challenge. This is due to such disorders being possibly related to posture, muscle condition, or even the state of cerebrospinal fluid.

Different approaches have targeted the suboccipital region for treating such pathologies. Research has talked about the myodural bridge. The said bridge is the connection between the muscles and the dura mater made by soft tissue. But there’s controversy regarding the myodural bridge.

Due to such a controversial status, some researchers feel, the doors to better diagnostic and therapeutic approaches are being blocked.

The current study decided to systematically review data regarding the soft tissue bridge existing between the cervical muscles and the dura mater in the upper cervical spine.

What Was the Methodology?

The team performed a systematic search of databases including PubMed, Cochrane Library, Web of Knowledge, and PEDro. The search was conducted between the 29th and the 31st of November 2015. There were no limits on the dates.

Articles (published in French, Portuguese, English, and Spanish journals) that reported original data about the continuity of non-post-surgical soft tissues between the dura mater and cervical muscles were included. Two members from the research team independently undertook the study selection process. A third member, if required, was used for resolving potential disagreements.

The Quality Appraisal of Cadaveric Studies (or the QUACS Scale) was used to assess the methodological quality of the selected studies.

What Were the Results?

The review was able to identify a total of 479 studies. After the review’s exclusion and inclusion criteria, only 26 studies were made part of the review. A strong level of evidence was observed about there being a particular soft tissue connection present. The said connection was seen between the rectus capitis posterior minor, the rectus capitis posterior major, as well as the obliquus capitis inferior muscles.

Controversy existed surrounding the possible communication between the dura mater and the serratus posterior superior, rhomboids minor, upper trapezius, and the splenius capitis through the ligamentum nuchae. 

The team found limited evidence about the rectus capitis anterior muscle and the dura mater having a soft tissue connection.

What Was Concluded?

According to the team involved, this review offered the first systematical evidence concerning the existence of the soft tissue connection present between the cervical dura mater and neck muscles. More research focusing on this particular connection could help create effective therapeutic and pathophysiological measures to better address craniocervical disorders as well as spinal health issues.