Connection between the spinal dura mater and suboccipital musculature: Evidence for the myodural bridge and a route for its dissection—A review

Abstract

A connective tissue link between the spinal dura mater and the rectus capitis posterior minor muscle was first described in 1995 and has since been readily demonstrated via dissection, magnetic resonance imaging, and plastinated cross-sections of the upper cervical region (Hack et al. [1995] Spine 20:2484-2486). This structure, the so-called "myodural bridge," has yet to be included in any of the American anatomy textbooks or dissection guides commonly used in medical education. This direct anatomic link between the musculoskeletal system and the dura mater has important ramifications for the treatment of chronic cervicogenic headache. This article summarizes the anatomic and clinical research literature related to this structure and provides a simple approach to dissect the myodural bridge and its attachment to the posterior atlanto-occipital membrane/spinal dura mater complex and summarizes the case for its possible inclusion in medical anatomy curricula.