title: Definition of the to be named ligament and vertebrodural ligament and their possible effects on the circulation of CSF.
abstract: Few studies have been conducted specifically on the dense connective tissue located in the posterior medial part of the cervical epidural space. This study was undertaken to examine the presence of this connection between the cervical dura mater and the posterior wall of spinal canal at the level of C1-C2. 30 head-neck specimens of Chinese adults were used. Gross dissection was performed on the suboccipital regions of the 20 specimens. Having been treated with the P45 plastination method, 10 specimens were sliced (9 sagittal and 1 horizontal sections). As a result, a dense fibrous band was identified in the nuchal ligament of 29 specimens (except for one horizontal section case). This fascial structure arose from the tissue of the posterior border of the nuchal ligament and then projected anteriorly and superiorly to enter the atlantoaxial interspace. It was termed as to be named ligament (TBNL). In all 30 specimens the existence of a fibrous connection was found between the posterior aspect of the cervical dura mater and the posterior wall of the spinal canal at the level of the atlas to the axis. This fibrous connection was identified as vertebrodural ligament (VDL). The VDL was mainly subdivided into three parts, and five variations of VDL were identified. These two structures, TBNL and VDL, firmly link the posterior aspect of cervical dura mater to the rear of the atlas-axis and the nuchal region. According to these findings, the authors speculated that the movements of the head and neck are likely to affect the shape of the cervical dural sleeve via the TBNL and VDL. It is hypothesized that the muscles directly associated with the cervical dural sleeve, in the suboccipital region, may work as a pump providing an important force required to move the CSF in the spinal canal.
authors.affiliation: Department of Anatomy, College of Basic Medicine, Dalian Medical University, Dalian, P. R. China.
authors.forename: Nan
authors.initials: N
authors.lastname: Zheng
authors.affiliation: Department of Anatomy, College of Basic Medicine, Dalian Medical University, Dalian, P. R. China.
authors.forename: Xiao-Ying
authors.initials: XY
authors.lastname: Yuan
authors.affiliation: Department of Anatomy, Zhongshan College of Dalian Medical University, Dalian, P. R. China.
authors.forename: Yun-Fei
authors.initials: YF
authors.lastname: Li
authors.affiliation: Department of Anatomy, College of Basic Medicine, Dalian Medical University, Dalian, P. R. China.
authors.forename: Yan-Yan
authors.initials: YY
authors.lastname: Chi
authors.affiliation: Dalian Hoffen Bio-Technique Co. Ltd., Dalian, P. R. China.
authors.forename: Hai-Bin
authors.initials: HB
authors.lastname: Gao
authors.affiliation: School of Art, Dalian Medical University, Dalian, P. R. China.
authors.forename: Xin
authors.initials: X
authors.lastname: Zhao
authors.affiliation: Department of Anatomy, College of Basic Medicine, Dalian Medical University, Dalian, P. R. China.
authors.forename: Sheng-Bo
authors.initials: SB
authors.lastname: Yu
authors.affiliation: Department of Anatomy, College of Basic Medicine, Dalian Medical University, Dalian, P. R. China; Dalian Hoffen Bio-Technique Co. Ltd., Dalian, P. R. China.
authors.forename: Hong-Jin
authors.initials: HJ
authors.lastname: Sui
authors.affiliation: National Training Centre, University of Chester, Dublin, Ireland.
authors.forename: John
authors.initials: J
authors.lastname: Sharkey
mesh_terms: D002555:Cerebrospinal Fluid / Q000502:physiology*; D002574:Cervical Vertebrae / Q000033:anatomy & histology*; D004824:Epidural Space; D005260:Female; D006801:Humans; D008022:Ligaments / Q000033:anatomy & histology*; D008023:Ligaments, Articular / Q000033:anatomy & histology*; D008297:Male
references.citation: Headache. 2004 Jan;44(1):84-9
references.pmid: 14979889
references.citation: Acta Anat (Basel). 1992;144(1):65-70
references.pmid: 1514362
references.citation: Spine (Phila Pa 1976). 2005 Jun 15;30(12):1359-66
references.pmid: 15959363
references.citation: J Manipulative Physiol Ther. 1998 Mar-Apr;21(3):145-8
references.pmid: 9567232
references.citation: Clin Anat. 2006 Sep;19(6):522-7
references.pmid: 16287092
references.citation: J Manipulative Physiol Ther. 1999 Oct;22(8):534-9
references.pmid: 10543584
references.citation: Spine J. 2013 May;13(5):558-63
references.pmid: 23406969
references.citation: Clin Anat. 2002 May;15(3):182-5
references.pmid: 11948951
references.citation: Spine (Phila Pa 1976). 1997 Apr 15;22(8):924-6
references.pmid: 9127929
references.citation: Clin Anat. 2013 May;26(4):444-9
references.pmid: 22577037
references.citation: Clin Anat. 2003 Mar;16(2):152-9
references.pmid: 12589671
references.citation: Spine (Phila Pa 1976). 1995 Dec 1;20(23):2484-6
references.pmid: 8610241
references.citation: Clin Anat. 2013 May;26(4):450-4
references.pmid: 22836789
references.citation: Wilhelm Roux Arch Entwickl Mech Org. 1929 Jun;118(1):252-307
references.pmid: 28354187
references.citation: Spine (Phila Pa 1976). 2000 Jan;25(1):5-9
references.pmid: 10647153
references.citation: Clin Anat. 2012 May;25(4):415-22
references.pmid: 22488993
references.citation: Spine (Phila Pa 1976). 2011 Dec 1;36(25):E1612-4
references.pmid: 21278628