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TECH 2701 Dentate Ligament

TECH 2701 Dentate Ligament - DENTATE LIGAMENT CORD...

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DENTATE LIGAMENT – CORD DISTORTION HYPOTHESIS John D. Grostic, D.C., F.I.C.R. Director Of Research Sid E. Williams Research Center Life Chiropractic College ABSTRACT The mechanism of nerve irritation resulting from upper cervical misalignments has usually involved either the nerve compression hypothesis or the proprioceptive insult hypothesis. Because of the diameter of the canal and the space between the cord and the wall of the canal, compression of the cord at the upper cervical area would require much larger displacements than are encountered in typical patients. The proprioceptive insult hypothesis does not adequately explain the sensory phenomena experienced by some upper cervical patients and is cumbersome to use in explaining the mechanism behind an upper cervical subluxation causing sciatica. The Dentate Ligament - Cord Distortion Hypothesis offers a mechanism whereby the effects of misalignments of the upper cervical vertebrae, via the dentate ligaments, produce mechanical distortions of the spinal cord. The clinical significance of the hypothesis and its relationship to supine leg length comparison, low back pain, and trigeminal neuralgia is discussed. Key Words: Subluxations, cervical, adjustment, dentate ligament, Grostic technique, neurological hypothesis. DENTATE LIGAMENT - CORD DISTORTION HYPOTHESIS From the time of D. D. Palmer to the present, the neurological component of the subluxation, i.e., interference with nervous system function has been a central tenet of chiropractic.(1-7) throughout the history of chiropractic various models and mechanisms have been developed to explain how vertebral misalignments produce this interference. These models have ranged from direct mechanical irritation of the spinal nerve or nerve root in the intervertebral foramen to the reflex hypotheses, e.g., somato-visceral, somato-psychic, etc.(8) While many of these hypotheses are credible and some are under investigation at this time, there are still several types of subluxations for which these explanations are inadequate.(5,8) Nowhere is this more apparent than in the upper cervical spine. In order to explain the upper cervical subluxation the proprioceptive insult hypothesis is usually cited. This hypothesis has been described in detail by Homewood and by Spencer.(5,9) This hypothesis states that the vertebral misalignment (or derangement) produces a hyperstimulation of proprioceptive nerve endings in and adjacent to the articulation. This hyperstimulation results in a barrage of proprioceptive signals into the spinal cord, and, it is hypothesized, causes an overload of the integrating circuits of the spinal cord. This results in impairment of the spinal cord at the level of the insult with possible effects being felt in other areas of the nervous system.(10,11) The proprioceptive insult hypothesis, plausible as it may be in explaining cord irritation generally, becomes complex when one tries to explain how an upper cervical subluxation can produce 1
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symptoms in the lower spine and extremities, e.g., sciatica. This hypothesis also fails to explain
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TECH 2701 Dentate Ligament - DENTATE LIGAMENT CORD...

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