Dural Connection Internet Edition    Volume 1, Number 4

This is the fourth of a series of abstracts of published articles relating to
Sacro Occipital Technique and Cranial Manipulation. Please use these for
educating insurance companies, the judiciary, the legislature, the colleges
and the interested public.

These grouping of abstracts focus on two themes. The first some articles by
Sacro Occipital Technique doctors in 1998 which have been published in peer
reviewed referenced journals. The second are some current anatomical
research findings regarding the discoveries of connective tissue attachments.



SOT Related Abstracts

Connelly, DM, Rasmussen, SA, The effect of cranial adjusting on
hypertension: A case report, Chiropractic Technique , May 1998, Vol. 10,
No. 2, pp. 75-78.

This is a report of three patients suffering from hypertension who were
treated using the sacro-occipital cranial technique, specifically the cranial
ranges of motion, and the cranial technique for reducing hypertension.
Favorable results were achieved in all three cases. This paper discusses the
outcome of these patient's treatments, and provides a possible mechanism for
the results.

Getzoff, H, The Step Out-Toe Out Procedure: A Therapeutic and Diagnostic
Procedure, Chiropractic Technique , August 1998, Vol. 10, No. 3, pp.
116-118.

This article provides a format of learning the Sacro Occipital Technique
(SOT) step out-toe out test (SOTO) and adjustment. This process is the core
part of SOT's category III (lumbopelvic problems) protocol. It serves to not
only identify and treat subluxations of the pelvis and lumbar spine, but also
determines the degree of involvement of the surrounding soft tissues.

Blum, CL, Curl, DD, The relationship between sacro-occipital technique and
sphenobasilar balance. Part One: The key continuities. Chiropractic
Technique , August 1998, Vol. 10, No. 3, pp. 95-100.

Careful inspection of the underlying theories and anatomical basis of the
many chiropractic techniques, including sacro-occipital technique (SOT),
reveals there are many procedures which are called upon to restore normal
function to the central and peripheral nervous systems. Chiropractors have
postulated that they have the ability to affect the nervous system and all
that it controls. SOT is reported to be able to accomplish this effect on
the nervous system; it views sacroiliac and lumbosacral imbalances in terms
of three categories with each category reflecting the method the body uses to
adapt to stress (e.g., physical stress).

This article describes a relationship between the SOT category system and
sphenobasilar symphysis positioning. To assist the reader in this
understanding various features from functional anatomy, orthopedic testing,
gait analysis and osteopathic theories will be used,

Part one of this article assists the reader in understanding various
continuities within the body as they exist between the central nervous system
and associated meninges and between the cranium and the pelvis. An
understanding of the mechanical stresses upon these areas is important for
every chiropractor.

Blum, CL, Curl, DD, The relationship between sacro-occipital technique and
sphenobasilar balance. Part Two: Sphenobasilar strain stacking,
Chiropractic Technique , August 1998, Vol. 10, No. 3, pp. 101-107.

Part one assisted the reader in understanding various continuities with
the body as they exist between the central nervous system and associated
meninges and between the cranium and pelvis.

Part two discusses how sacro-occipital technique (SOT) category
distortions can be affected when treating the sphenobasilar symphysis. The
"Sphenobasilar Strain Stacking" technique is presented as a method of
affecting SOT distortions.


Connective Tissue Attachments

Shinomiya, K, Dawson, J, Spengler, DM, Konrad, P, Blumenkopf, B, An
analysis of the posterior epidural ligament role on the cervical spinal cord.
Spine , September 1996, 21(18): pp. 2081-2088.

The role of the posterior cervical epidural ligaments is to anchor the
posterior dura mater to the ligamentum flavum. Laminectomy was performed on
cats to destroy the posterior epidural ligament. Evoked potentials and
spinal cord blood flows quantified the spinal cord function before and after
cervical flexion. The study found that the loss of the ligaments allows
anterior displacement of the posterior dura mater in flexion. Abnormal
distribution of or lack of the cervical posterior epidural ligaments may lead
to flexion myelopathy.

Hack, GD, Koritzer RT, Robinson WL, Hallgren RC, Greenman PE, Anatomical
relation between the rectus capitis posterior minor muscle and the dura
mater. Spine , December 1995, 20(23): pp. 2484-2486.

This study explored an anatomical study of the suboccipital region,
specifically the deep muscles of the suboccipital triangle, performed on
cadaveric specimens. A connective tissue bridge between the rectus capitis
posterior minor muscle and the dorsal spinal dura at the atlanto-occipital
junction was observed in each of the eleven (10 embalmed and 1 fresh)
sagittally hemisected head and neck specimens. The arrangement of the fibers
appear to resist movement of the dura towards the spinal cord.
Awareness of the physical relation between the rectus capitis posterior
minor muscle and spinal dura via this connective tissue bridge should lessen
the potential risk of dural damage during surgery. This connective tissue
bridge may help resist dural infolding during head and neck extension.

Dunn, GF, Hack, GD, Robinson WL, Koritzer RT, Anatomical observation of
a craniomandibular muscle originating from the skull base: the
sphenomandibularis. Cranio , April 1996, 14(2): pp. 97-103.

The study describes a hitherto unreported, functionally distinct
craniomandibular muscle as observed in 25 cadaveric specimens and MRI scans
of clinical patients. The muscle was consistently observed as originating
from the maxillary surface of the sphenoid bone and inserting on the temporal
crest (internal oblique line) of the mandible. This anatomic observation
should broaden our understanding of craniomandibular function and may have
clinical implications regarding retro-orbital pain.

Shankland, WE 2d, Negulesco, JA, O'Brian, B, The "pre-anterior belly" of
the temporalis muscle: a preliminary study of a newly described muscle,
Cranio , April 1996, 14(2): pp. 106-112.

Gross anatomical structures of the human body have been known and taught to
students for centuries. However, at times, anomalies or even previously
undescribed structures are discovered and subsequently reported. This
preliminary report discusses the discovery of either a previously undescribed
belly of the temporalis muscle, a previously undescribed muscle of
mastication, or simply an anomaly of the temporalis. The somatosensory
innervation of this structure is identified and presented. Preliminary
measurements of this structure are provided. Finally, clinical implications
of these findings, which may aid in the diagnosis and treatment of temporal
and facial pain, is discussed.

Cole, SV, Smith JE, Frequency of occurrence of the zygomandibularis muscle:
a recently described structure, Cranio , October 1997, 15(4): pp, 310-313.

Many anatomical variations of the infratemporal area exist: muscle
fusion, muscle belly separation, distinctly different origins, and both
separate and aponeurotic insertions. This study attempted to find the
frequency of occurrence of the zygomandibularis muscle, a recently described
human structure. The zygomandibularis muscle may occur unilaterally,
bilaterally, or may be absent, in this study, 23 female Caucasian cadavers
and 27 male Caucasian cadavers were evaluated; the zygomandibularis muscle
was found in 42% of the population of 50 cadavers.

Barker, BC, The pterygoideus proprius muscle, Aust Dent J , October 1981,
26(5): pp. 309-310.

An anomalous muscle was found in the infratemporal fossa of a male
cadaver of advanced age. This formation passed between fixed bony
attachments at the infratemporal crest (greater wing of the sphenoid) and the
inferior part of the lateral pterygoid plate. The muscle was not atrophied
but its functional significance was not clear.

Mitchell, B, Humphreys, BK, O'Sullivan, E, 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)

This study attempts to describe by way of an anatomically a previously
unrecorded attachments of the ligamentum nuchae to the cervical posterior
spinal dura, and to the posterior parts of the occipital bone, with
particular reference to the deep aspects of the suboccipital triangle and
upper cervical region. 

In ten parasagittally-sectioned material, continuity was observed between the ligamentum nuchae and the posterior cervical spinal dura as the later
passed deeply from the midline toward the dura, but only at the first and
second cervical vertebral levels. The ligamentum nuchae also passed
bilaterally on to the occipital bone as far as the sutures between the latter
and the temporal bones, approaching the inferior nuchal line superiorly.
This is of significance for understanding the biomechanics of the
cervical spine, particularly rotational movements of the head in the sagittal
or transverse planes. This may have implications in manipulative therapy
for conditions as cervicogenic headache and for various degenerative
disorders affecting the cervical spine.


Bashline, SD, Bilott, JR, Ellis JP, Meningovertebral ligaments and their
putative significance in low back pain, Journal of Manipulative and
Physiological Therapeutics , Nov-Dec 1996, 19(9): pp. 592-6.

This study attempted to determine the presence and morphology of the
meningovertebral ligaments (ligaments of Hofmann) as well as postulate their
possible contribution to low back pain. Sagittal dissections were performed
on 12 embalmed cadaver specimens including the L5/S1 intervertebral level
cephalad to T1. Meningovertebral ligaments were labeled and documented in
both the lumbar and thoracic regions.

Meningovertebral ligaments were found in both the lumbar and thoracic
regions of all cadaveric specimens. These ligaments were much more prevalent
in the lumbar vertebral column but were also present throughout the thoracic
vertebral column. The meningovertebral ligaments in the lumbar region were
more robust as well as more frequently encountered than those found in the
thoracic region.

Dural sac attachments to the posterior aspect of the vertebral bodies
and the posterior longitudinal ligament could act to traction the dural sac
in the event of nuclear bulge or herniation. The prevalence of these ligaments in the lumbar spine, coupled
with the high incidence of herniated nucleus pulposus and disc bulges in this
region, may compound the effects of disc pathology and result in increased low back pain.

Dural Connection Internet Edition Index