Spinal Cord and Brain Stem Tension

Dr. Haralambous recognizes that deviations from the normal spine will induce tension upon the spinal cord and
brain stem. This tension, over time, interferes with the normal functions of the central nervous system. Alf Breig,
MD, a Swedish neurosurgeon, did extensive research on the biomechanics of the central nervous system. His
findings provide solid evidence that these pathological tensions occur with postural deviations. Dr. Breig has
also shown that with degenerative changes of the spinal column, these tensions can be severely magnified. The
following is a summary of his findings.

Anatomy
The spinal cord is encased within three meningeal layers known as the dura mater, arachnoid mater, and pia
mater. The dura mater is the outermost layer and attaches to the foramen magnum, C1, C2, C3, and the coccyx
via the filum terminale. It provides a protective covering around the entire cord and nerve roots. The arachnoid
mater is the middle layer which functions as the cerebrospinal fluid barrier. Inside the arachnoid CSF circulates
around the cord, bathing it in essential nutrients. The innermost layer is the pia mater which is directly attached
to the spinal cord. The pia mater forms the dentate ligaments which run bilaterally between the nerve rootlets
down the entire length of the cord to the conus medullaris. The dentate ligaments are rhomboid shaped and
extend laterally between each nerve root level, attaching to the dura mater. They function to suspend the cord
within the dura mater and to distribute forces along the entire length of the cord. At the conus medullaris the pia
mater continues, with a sheath of dura, down through the cauda equina as the filum terminale, where it attaches
to the coccyx.   Due to the attachments of the spinal cord to the meninges and of the meninges to the spinal
canal, the cord is indirectly fixed to the spinal canal. It is apparent that short term changes in posture and
movement of the vertebral column must be exactly duplicated by the deformation of the spinal cord in
symmetrical harmony.

Spinal Canal
The axis of curvature of the spinal column is through the posteriocentral vertebral bodies. This means that in
flexion, any structures anterior to this axis will be compressed and any structures posterior will be put under
tension. Likewise, in extension, any structures posterior will be compressed and any anterior will be tensed. The
spinal canal which holds the spinal cord is found posterior to the axis of curvature and is therefore subject to
changes in length with flexion and extension.
The cervical canal lengthens with flexion and shortens with extension. With rotation the canal becomes
narrowed. With lateral flexion the canal lengthens on the convex side and shortens on the concave side. Similar
changes occur in the lumbar canal. The spinal cord running through the canal must deform in perfect unison with
any change in size or shape of the canal.

Spinal Cord, Nerve Roots, and Cord Vessels
From the maximum positions of lordosis to kyphosis cervical, thoracic, and lumbar spine lengthening of the cord
was 1.8-2.8 cm, 0.9-1.3 cm, and 1.0-2.0 cm, respectively. Also, with flexion, the cord decreases in
cross-sectional area. In extension, the cord becomes relaxed and somewhat undulated, increasing in
cross-sectional area . With the cervicals in extension, no physiological position could elicit any tension in the
cord. With lateral flexion of the cervical spine, the cervical cord lengthened about 6 cm on the convex side and
was compressed the same amount on the concave side.
The nerve roots along with their dural sleeves are stretched cephalad in flexion of the spine. The dural sleeve
actually comes in contact with the superior pedicle. In extension, the nerve roots and dural sleeves become
relaxed.
The blood vessels of the cord are also affected. In flexion, they are pulled taught causing their lumina to
decrease in cross-sectional area. In extension, the vessels assume a relaxed appearance, with their lumina
increasing in cross-sectional area.  In short, the blood supply in the spinal cord and brain stem can be severely
reduced.

Brain Stem and Cranial Nerves
Due to movements in the atlanto-occipital and atlanto-axial articulations with flexion, extension, and lateral
flexion of the head and cervical spine, there is a lengthening and shortening of the brain stem, parts of the
cerebellum, and the cranial nerves in the posterior fossa. The posterior part of the medulla oblongata
undergoes the greatest deformation.
From maximum positions of flexion to extension the brain stem lengthens 0.8-1.4 cm. When compared to the
relative length of the thoracic cord, the brain stem actually has more deformation. In flexion, the floor of the fourth
ventricle becomes longer and narrower. Also, the cross-sectional area of the brainstem is decreased in flexion.
In extension, the brain stem becomes relaxed, increasing in cross-sectional area with the floor of the fourth
ventricle widdening and flattening.
In flexion, the cranial nerves are pulled taught from their attachments at the brain stem to respective foramina. In
extension, they become relaxed.  Intrestingly, the trigeminal nerve (cranial nerve 5), receives the greatest
mechanical insult.  Correcting poor posture can relax this pathological tension, and may explain why Dr.
Haralambous has had such great success with conditions like Headaches, Trigeminal Neuralgia, and TMJ.

Conclusion:
The tensions Dr. Alf Breig talks about occur with every range of motion the human spine goes through. This is
normal and does not cause nerve interference because these tensions are temporary since they dissipate when
we return to normal upright posture. These tensions become pathological when there is a continual or
permanent deviation from normal upright posture. As we know, postural deviations are caused by macro and
microtrauma. These traumas can cause scar formation in and around the spinal cord and meninges. Postural
deviations will lead to degenerative changes in the spinal column such as abnormal bone growth in the spinal
canal, disc protrusions, or fibrotic adhesions. Any pathological change in the tissue of the spinal cord or
surrounding tissues, along with abnormal posture, will create enough tension in the CNS to cause symptomatic
nervous interference. Tensions which create asymptomatic nervous interference have not and may never be
determined. Therefore the best cure for nervous interference caused by tension of the CNS is prevention. This
can only be achieved by returning the posture to normal.

Spinal Cord and Brain Stem Tension   Bone Deformation
Restricted Blood Flow   Nerve Root Compression