Philip E. Greenman

Anatomic Relation between the Rectus Capitis Posterior Minor Muscle and the Dura Mater

Study Design Anatomic study of the suboccipital region, specifically the deep muscles of the suboccipital triangle, was performed in cadaveric specimens. Objective To observe and describe the relationship between the deep subocipitel musculature and the spinal dura. Summary of Background Data A review of the literature revealed no reports describing a physical connection between suboccipital musculature and the spinal dura. Methods Dissections of the suboccipital region were performed in 10 embalmed and one fresh sagittally hemisected head and neck specimens. Results Aconnective tissue bridge between the rectuss capitis posterior minor muscle and the dorsal spinal sura at the atlanto-occipital junction was observed in every specimen. the fibers of the connective tissue bridge were oriented primarily parpondicular to the dura. This arrangement of fibers appears to resist movement of the dura toward the spinal cord. Conclusions Awareness of the physical relation between the rectus capitis posterior minor muscle and spinal dura via this connective tissue bridge should lesson the potential risk of durel damage during surgery. This connective tissue bridge may help resist dural infolding during head and meck extension.

Neurogenic atrophy of suboccipital muscles after a cervical injury: a case study.

This case report describes abnormalities in bilateral rectus capitis posterior minor muscles in one individual with persistent head and neck pain. These findings are muscle atrophy, fatty infiltration on magnetic resonance imaging, and electromyographic abnormalities compatible with denervated muscle. The objective of the study contained herein was to determine if fatty infiltration on magnetic resonance imaging of the rectus capitis posterior minor muscle is the result of disuse or denervation. Electromyography and magnetic resonance imaging data were collected from normal and atrophied muscles. Electromyography and magnetic resonance imaging abnormalities compatible with denervation atrophy were detected. Although we cannot rule out aging or other unknown causes, we suspect that denervation is caused by nerve damage from trauma to the C1 dorsal ramus as a consequence of entrapment within the rectus capitis posterior major muscle.

Manipulative Therapy in Relation to Total Health Care

The history of manipulation is as old as the history of medicine itself (Cyria & Schiotz, 1975). Hippocrates, the acknowledged father of medicine, apparently used manipulative therapy in patient care. His disciples, and subsequent physicians throughout the ages, have applied manual therapy to the human body. A study of the history of manipulative therapy or manual medicine leads one to two basic conclusions. In the first instance, most manipulative therapy was utilized for the treatment of “structural” problems. Treatment was designed to restore altered structure to a more “normal” condition. The treatment of kyphosis, lordosis, and scoliosis, by varying means of traction, compression, and other manual forces, was apparently to restore structural form. In the second instance, much of the therapy was on the basis of empirical result, rather than upon the basis of “scientific” research and study. If the therapy was effective, it was utilized.

January 1986 Letters to the Editor-in-Chief

Letters to the Editor-in-Chief of JOSPT as follows: Letters regarding “May-June 1984 Letters to the Editor-in-Chief” J Orthop Sports Phys Ther 1986;7(4):199-201. doi:10.2519/jospt.1986.7.4.199