• Nan Zheng, Beom Sun Chung, Yi-Lin Li, Tai-Yuan Liu, Lan-Xin Zhang, Yang-Yang Ge, Nan-Xing Wang, Zhi-Hong Zhang, Lin Cai, Yan-Yan Chi, Jian-Fei Zhang, Okoye Chukwuemeka Samuel, Sheng-Bo Yu, and Hong-Jin Sui.
• Department of Anatomy, College of Basic Medicine, Dalian Medical University, 9 West Section, Lushun South Road, Dalian, People's Republic of China.
• Surg Radiol Anat. 2020 Feb 1; 42 (2): 143-153.

PurposeThe connective tissue between suboccipital muscles and the cervical spinal dura mater (SDM) is known as the myodural bridge (MDB). However, the adjacent relationship of the different connective tissue fibers that form the MDB remains unclear. This information will be highly useful in exploring the function of the MDB.MethodsThe adjacent relationship of different connective tissue fibers of MDB was demonstrated based upon three-dimensional visualization model, P45 plastinated slices and histological sections of human MDB.ResultsWe found that the MDB originating from the rectus capitis posterior minor muscle (RCPmi), rectus capitis posterior major muscle (RCPma) and obliquus capitis inferior muscle (OCI) in the suboccipital region coexists. Part of the MDB fibers originate from the ventral aspect of the RCPmi and, together with that from the cranial segment of the RCPma, pass through the posterior atlanto-occipital interspace (PAOiS) and enter into the posterior aspect of the upper cervical SDM. Also, part of the MDB fibers originate from the dorsal aspect of the RCPmi, the ventral aspect of the caudal segment of the RCPma, and the ventral aspect of the medial segment of the OCI, enter the central part of the posterior atlanto-axial interspace (PAAiS) and fuse with the vertebral dura ligament (VDL), which connects with the cervical SDM.ConclusionsOur findings prove that the MDB exists as a complex structure which we termed the 'myodural bridge complex' (MDBC). In the process of head movement, tensile forces could be transferred possibly and effectively by means of the MDBC. The concept of MDBC will be beneficial in the overall exploration of the function of the MDB.

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