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REVIEW ARTICLE

Sutherlands Legacy in the New Millennium:


The Osteopathic Cranial Model and Modern
Osteopathy
Bruno Bordoni, DO; Emiliano Zanier, DO

ABSTRACT
The concept of cranial osteopathy was introduced by
W. G. Sutherland, DO, and became the foundation for
setting the rules for use of skull palpation and many other
techniques in the many types of dysfunctional patterns
that craniosacral therapy treats. Sutherlands theories
enabled modern osteopathy to develop and improve. The
mechanism of primary respiration as well as the motion of
neurocranial and viscerocranial sutures are phenomena
intrinsic to the field and can be found in every living

Bruno Bordoni, DO, is an osteopath and physiotherapist at


S. Maria Nascente Don Carlo Gnocchi Foundation IRCCS,
Department of Cardiology, in Milan, Italy, and is scientific
director and professor at School CRESO, Osteopathic
Centre for Research and Studies, Falconara Marittima, in
Castellanza, Italy. Emiliano Zanier, DO, is an osteopath and
physiotherapist at Edi Academy in Milan and a professor at
School CRESO, Osteopathic Centre for Research and
Studies, Falconara Marittima.
Corresponding author: Bruno Bordoni, DO
E-mail address: bordonibruno@hotmail.com

he sphenobasilar synchondrosis (ie, the joint between


the base of the occiput and the body of the sphenoid
bone) is the pivotal location in the body that sustains the
cranial model that was developed by W. G. Sutherland, DO,1 the
father of osteopathy in the cranial field (see Figure 1). According
to Sutherland, a connected, rhythmic and autonomous event or
movement can shift the aforementioned joint, consequently
affecting the reciprocal tension membranes (RTMs) and the
sutures of the skull. This mechanism is called primary respiration.
The concept of palpatory sensations that can be perceived
by a practitioner when touching the skull was based on
Sutherlands model as were further mechanical outlines
intended for classifying possible dysfunctions while
BordoniOsteopathic Cranial Model and Modern Osteopathy

organism, independent of thoracic breathing and cardiac


impulse. The sphenobasilar synchondrosis (ie, the joint
between the base of the occiput and the body of the
sphenoid bone) is the pillar supporting the concepts of
craniosacral therapy. This article compares the cranial
model devised by Sutherland with the present, relevant
scientific research, aiming at clarifying the possibility of
applying the craniosacral model in the new millennium.
(Adv Mind Body Med. 2015;29(2):15-21.)

suggesting specific manual treatments or determining the


presence of physiological rhythms.2
Although craniosacral therapy is taught as an absolutely
valid method of therapy, the literature about its efficacy is still
controversial.3,4 However, this article does not propose to verify
its effectiveness but rather to place Sutherlands model within
the framework of modern scientific knowledge, trying to
understand whether it is necessary to create new palpatory
techniques in light of new scientific information. It discusses
forensic studies regarding the ossification of the sphenobasilar
synchondrosis and of some sutures of the skull. It also considers
research on a cranial rhythm that is assessable by palpation and
on the forces that affect this rhythm. Finally, it briefly addresses
the mechanical properties of the cranial bones, mentioning
differences in bone tissue that depend on the age of an individual
and on the presence of pathologies that could alter its
composition, which therapists must take into consideration.
OSSIFICATION
The sphenobasilar joint is defined as a synchondrosis
(ie, a cartilaginous union between 2 immovable bones) until
the cartilage turns into bone in adulthood.5 The embryological
origin of the occipital and sphenoid bone is dual, given that
a mesenchymal and an ectodermic portion are observable.6,7
The cranial model is used as a standard one in cranial
osteopathic treatment, but it does not take into consideration
the differences among age groups and, consequently, the
different types of ossification of the joint.8

ADVANCES, SPRING 2015, VOL. 29. NO. 2

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Figure 1. The external surface of the skull base. The sphenobasilar synchondrosis (ie, the joint between the base of the occiput
and the body of the sphenoid bone) is the pivotal location in the body that sustains the cranial model that was developed by
Dr W. G. Sutherland, the father of osteopathy in the cranial field.1

1 Incisor forum
2 Maxillary bone
3 Zygomatic process of the maxilla
4 Greater forum palatine
5 Lower orbital fissure
6 Zygomatic bone
7 Temporozygomatic suture
8 Pterygoid process
9 Great wing of the sphenoid
10 Suture sphenosquamosal
11 Oval forum
12 Spinous forum
13 Lacerated forum
14 Pyramid of the temporal
15 External acoustic meatus

16 Carotid canal
17 Jugular forum
18 Foramen magnum
19 Mastoid notch
20 Inferior nuchal line
21 Nuchal plane
22 Superior nuchal line
23 External occipital crest
24 Inion
25 Lambdoid suture
26 Mastoid forum
27 Occipitomastoid suture
28 Mastoid process
29 Occipital condyle
30 Stylus mastoid forum

31 Styloid process of the temporal


32 Basal portion of the occiput
33 Mandibular fossa
34 Groove of auditory tube
35 Spheno-occipital synchondrosis
36 Wings of the vomer
37 Zygomatic arch
38 Pterygoid hook
39 Inferior nasal concha
40 Zygomatic maxillary suture
41 Inferior nasal spine
42 Horizontal lamina of the palatine
43 Transverse palatine suture
44 Median palatine suture
45 Palatine process of the maxilla

Reproduced with permission from Anastasi G, Balboni G, Motta P. Trattato di Anatomia Umana. 4th ed. Milan, Italy: Edi.Ermes; 2014.

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ADVANCES, SPRING 2015, VOL. 29, NO. 2

BordoniOsteopathic Cranial Model and Modern Osteopathy

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Medical literature shows that ossification of the


synchondrosis, as a general rule, is almost complete by the
end of puberty and occurs through a process that begins at
the level of the endocranial surface and then continues
finally to the ectocranial level.5,9,10 The onset of ossification of
the sphenobasilar synchondrosis occurs 2 to 3 years earlier
for girls than it does for boys.11 Krishan and Kanchan9 found
that the average age for complete ossification of the
synchondrosis was around 21 years for males and 19 years
for women. According to other studies, complete ossification
occurs earlier (ie, at the age of 17 y for boys and 15 y for
girls).5 More accurate studies based on race and geographic
areas are still needed, but current research supports the
concept that ossification of the joint between the occiput and
the sphenoid has concluded by the end of adolescence.9
Based on current scientific data, the authors propose
that the cranial model, as devised by Dr Sutherland, should
be revised with reference to adults, because their sphenobasilar
synchondroses will have ossified and prevent any movement
that could influence the RTMs and sutures. Similarly, a
revision should occur for any dysfunctional patterns that are
known through osteopathy and obtained through review of
that scientific data. In immature individuals, however, this
model could still be valid. No studies have been carried out
using magnetic resonance imaging (MRI) that confirm the
movement of this joint in live subjects, whether adults or
children.
SUTURE DEVELOPMENT
Every structure present in the human body is useful and
serves 1 or more purposes. Cranial sutures are defined as
synarthroses and correspond to the bones that constitute the
skull and that are joined together by fibrous tissue. In adults,

scientists can identify 15 sutures.7 The embryological


development of the skull begins between the 23rd and 24th
day of gestation and derives from the mesoderm and the
ectomesenchyme. The dura mater appears later, between the
51st and 53rd day of gestation.7 The neurocranium develops
from the mesenchymal tissue surrounding it while the
viscerocranium derives from the first 3 branchial arches; the
cranial base, the chondrocranium, and the cranial vault lie
within the neurocranium.
The cranial sutures carry out a fundamental role in the
cerebral growth of a child, adapting themselves to the volume
increase of the central nervous system.12 The sutures are
important in the adult as well; they can expand due to an
increased internal pressure (blood pressure) and can adapt to
the forces originating in the muscles involving the skull.
Further, they allow the dispersion and cushioning of traumas,
both in adults and children12 (see Figure 2).
Sutures play important mechanical roles as well.12 The
capacity of the sutures to absorb tension depends on their
inherent viscoelastic composition; they are made from the
extracellular matrix, which is rich in collagen fibers,
proteoglycans, and water.12 The sutures do not possess an
identical elastic module; they have various capacities for
absorbing tension. In fact, sutures with interdigitations
(eg, the occipitoparietal suture) typically show a broader
elastic model.12
The sutures of the facial area play an important role in
adolescence because they permit proper growth, whereas the
other sutures of the skull are fundamental before puberty.13
Recent research carried out on sutures through
microcomputed tomography has proven that some bone
junctions, particularly craniofacial sutures, are still partially
open in adults and in the elderly.13,14 Other studies have

Figure 2. Skull of a newborn in the lateral view. The cranial sutures carry out a fundamental role in the cerebral growth of a
child, adapting themselves to the volume increase of the central nervous system.12 The picture shows a skull of a child and its
sutures in the developing.
1 Anterior fontanel
2 Sphenoid fontanel
3 Cartilage of the septum
4 Mental forum
5 Sheath of styloid process
6 Stylus mastoid forum
7 Mastoid forum
8 Mastoid suture
9 Mastoid fontanel

Reproduced with permission from Anastasi G, Balboni G, Motta P. Trattato


di Anatomia Umana. 4th ed. Milan, Italy: Edi.Ermes; 2014.

BordoniOsteopathic Cranial Model and Modern Osteopathy

ADVANCES, SPRING 2015, VOL. 29. NO. 2

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suggested that some sutures, such as the occipitomastoid and


the parietomastoid, continue being nonossified up to 80
years of age; the sphenoparietal and the sphenofrontal
remain open until at least 60 years of age.15 However, further
studies are needed on all of the sutures of the skull, carried
out with identical instrumental methods of investigation.
Thanks to the existence of data from prior studies, the
authors speculate that nonossified sutures still have a role in
permitting movement, supporting Sutherlands cranial model
on skull mobility.
CRANIAL RHYTHM
The scientific literature is not unanimous in affirming
that the skull moves.15 Can human palpation perceive these
tiny movements? According to a recent study, human touch
can assess them, distinguishing any variations, measurable in
microns.16
Cranial rhythm is scientifically measurable. From the
osteopathic perspective, the cranial rhythm related to
primary respiration is divided into cranial flexion or
inspiration and cranial extension or expiration.17 This rate
varies between 10 and 14 cycles per minute.18 A recent study
has revealed how this cyclical fluctuation is associated with
the oscillation of blood velocity and is named the TraubeHering oscillation.18,19
The vasomotor activity is independent of heartbeat and
respiration. It is, however, determined by the autonomous
pulsation of lymphatic and blood vessels within the brain
mass, thanks to the action of the nervous vegetative system.20
The authors of a study based on the measurement of blood
flow have theorized that the aforementioned fluctuations and
primary respiration are the same.18 However, no study has
proven the connection between the velocity of blood flow
and the sutures of the skull.
Do other forces exist that could generate possible cranial
rhythms? Some research has shown that forces exist that can
move the brain mass cranio-caudally and can affect the
synthesis of cerebro-spinal fluid (CSF), mechanisms that are
particularly significant in reference to Dr Sutherlands cranial
model.18,20
The heart is the most important vascular instrument in
determining the displacement of the cerebral mass as well as
in influencing the behavior of the CSF.18,20 Using MRI, it has
been shown that the brain mass and the medulla oblongata
move caudally and medially (2-3 mm) during the systole,
whereas concurrently with the diastole, a cranial return has
been observed.18,20 The arterial expansion brought about by
the action of the systole determines a sort of piston effect that
compresses the ventricles, filling the subarachnoid area and
the spinal duct with the CSF.20,21 During the diastole, the
blood volume of the cerebral arteries is reduced, the pressure
decreases, and a cranial return of the cerebral mass can be
observed.20,21
The muscle of the respiratory diaphragm can move the
cerebral mass and influence the CSF.20,21 Whether by unforced
and less emphatic breaths, or by forced breaths with the same

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ADVANCES, SPRING 2015, VOL. 29, NO. 2

force as the myocardium, the diaphragm directs the


movement of the brain mass, resulting in a change in
position of the CSF.20,21 During inhalation, scientists have
observed a cranial return to the central nervous system,
whereas during exhalation, the movement is toward the
cauda.20 The current authors could logically hypothesize that
the 2 systems, namely the respiratory and cardiac ones, work
in perfect synergy with regard to the CSF fluctuations and
the brain mass. However, further studies are needed for
scientific confirmation.
Do these variations in the positions and pressures of the
brain affect the activity of the sutures? Herring12 has shown
that the sutures can expand because of increased intracranial
pressure, thereby preserving the integrity of the cerebral
mass. Based on current scientific data, the current authors
can affirm that Dr Sutherlands cranial model, which involves
a spontaneous movement of the brain with consequent
pressing of the ventricles, should be revised, both for adults
and children.20 Dr Magouns cranial model should be revised
as well, because scientists already know that no spontaneous
rhythmic secretion of the cerebrospinal fluid occurs with a
related movement of the brain, but, rather, it occurs through
the effect of heartbeat and respiration, with the involvement
of the autonomous system.20
THE TRANSMISSION OF CRANIAL BONES
The cranial bones of healthy adults consist mainly of 3
layers, with the external layer being very compact and having
a high percentage of bone density, whereas the other layers
present a lower bone density and irregular porosity.22 The
innermost layer can easily absorb mechanical energy, both
from the outside (eg, through trauma) and the inside
(eg, through liquid pressures).22 See Figure 3 and Figure 4.
Childrens skulls also have these layers, but they are
arranged differently and have a nonhomogeneous thickness.
Hence, their capability to absorb mechanical tension is
different.22,23
In addition, clarification is needed on how and when
changes in the arrangement of the layers occur in adolescent
or adulthood. Extensive cranial growth occurs between the
ages of 13 months and 18 years; however, the effect that this
growth has on the mechanical properties of the pediatric skull
during this transitional period remains largely undocumented.23
As periosteal tissues expand in response to the developing
brain, the bones of the cranium move apart, straining the
sutures and simultaneously creating space for and signaling
for the growth of new bone.23 The bone also transitions from
the single layered structure observed in early childhood to
the trilayer bone present in adults, which is composed of a
cortical table on both the ecto- and endocranial surface,
separated by a porous trabecular layer. This layering occurs
by the simultaneous deposition of new bone on both the
ectocranial and endocranial surfaces and the resorption of
the inner layer. These 2 modes of growth, resulting in the
nonuniform development of the pediatric skull, may create
regional variations in mechanical properties.23
BordoniOsteopathic Cranial Model and Modern Osteopathy

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Figure 3. Representation of the venous sinuses of the dura mater in a sagittal section of the skull. The venous system of the skull
is an important subject from the point of view of the osteopath, according to the teachings of Sutherland.1 The innermost layer
can easily absorb mechanical energy, both from the outside (eg, through trauma) and the inside (eg, through liquid pressures).22
1 Veins of the dura mater
2 Superior sagittal sinus
3 Left middle cerebral vein
4 Left sinus sphenoparietal
5 Intercavernous sinus
6 Left inferior petrosal sinus
7 Left superior petrosal sinus
8 Left sigmoid sinus
9 Occipital sinus
10 Confluence of sinuses
11 Left transverse sinus
12 Straight sinus
13 Great cerebral vein (of Galen)
14 Inferior sagittal sinus
15 Superior sagittal sinus
16 Falx cerebri
Reproduced with permission from Anastasi G, Balboni G, Motta P. Trattato di Anatomia Umana. 4th ed. Milan, Italy: Edi.Ermes; 2014.

Figure 4. Front section of the skull. The image shows the continuity of the tissues that form the various layers of the skull,
from the outside inward and vice versa. As periosteal tissues expand in response to the developing brain, the bones of the
cranium move apart, straining the sutures and simultaneously creating space for and signaling for the growth of new bone.23
The bone also transitions from the single layered structure observed in early childhood to the trilayer bone present in adults,
which is composed of a cortical table on both the ecto- and endocranial surface, separated by a porous trabecular layer.23
1 Frontal and parietal branches of the
superficial temporal artery
2 Frontal and parietal branches of the
superficial temporal vein
3 Fascia galea
4 Vault the skull
5 Dura mater (2 layers)
6 Telencephalic cortex
7 Arachnoid
8 Space subaracnoidal
9 Pia mater
10 Cerebral artery
11 Superior cerebral vein
12 White matter
13 Falx cerebri
14 Inferior sagittal sinus
15 Epidural space
16 Aracnoidal granulation
17 Superior sagittal sinus
18 Skin
19 Pericranium
20 Emissary vein
Reproduced with permission from Anastasi G, Balboni G, Motta P. Trattato di Anatomia Umana. 4th ed. Milan, Italy: Edi.Ermes; 2014.

BordoniOsteopathic Cranial Model and Modern Osteopathy

ADVANCES, SPRING 2015, VOL. 29. NO. 2

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Scientists do not know the composition of the skull and


its biomechanical behavior in the presence of a disease; they
also do not know how it can adapt in the case of tensional
changes. The viscoelastic deformation of bone tissue depends
on the mineral density of the bone, and a change in its
composition can negatively affect the elastic property of the
tissue.24 Thanks to studies carried out with the objective of
comprehending the brain damage that is caused by traumas,
scientists can affirm that changes in the position of the brain
are transmitted to the bones of the skull, and vice versa,
through the passage of RTMs.25 The RTMs strongly affect the
patterns of propagation of the mechanical wave toward the
brain.25 From inside, an analogous mechanism of tensional
transmission toward the outside can be observed as well.25
Even the muscles of mastication, once activated, can transmit
the generated tension vertically and horizontally.26 Scientists
still do not know, however, what happens to the distribution
of the tension that originates in the muscles involved in
mastication in the presence of pathological dysfunctions.
Another important concept to point out is that the
transmission of tension plays a significant role for the health
of the bone itself, because the passage of tension brings about
the activation of biochemical responses or mechanotransduction, enabling the functional adaptation of
osteoblasts.27 This action preserves the integrity and the
metabolic capacity of the bones.27
The authors hypothesize that the capacity of the skull
bones to transmit mechanical information (eg, a movement
of the brain mass that is perceivable through palpation of
stretched sutures by a practitioner) will be affected in cases of
pathology. This fact means that the patterns of palpation in
craniosacral therapy may need to be reassessed. However, the
authors await further studies to determine the authenticity of
this assumption.
CONCLUSIONS
Scientists know that hydrostatic pressure in the cerebral
mass can transmit oscillatory waves towards the skull bones;
they also know that skull sutures can expand to adapt better
to the increase in internal pressures.12,28 As far as sphenobasilar
joint ossification is concerned, the literature supports its
complete ossification by the end of adolescence.5,9-11 Scientists
are aware that different cranial rhythms can be observed, and
some of these can be measured and evaluated through
palpation.18,20,21 However, they do not know what happens if
the viscoelasticity of bone tissue changes its intrinsic
mechanical property (eg, in the case of disease) and how the
sutures and the RTMs react.
In the new millennium and in light of the data discussed,
scientists should review the existing cranial models with
respect to the model developed by Dr Sutherland. This
requirement is particularly true with reference to the adult,
to develop the osteopaths knowledge and to increase the
effectiveness of treatment for a patient. Almost certainly, the
conventional patterns for assessing any dysfunction in
children might still be valid.29 The considerations presented

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ADVANCES, SPRING 2015, VOL. 29, NO. 2

in this article could have an impact on clinical practice, but,


currently, no other articles discuss them. The authors are
confident that the current article can drive and encourage
practitioners to continue doing further research, with the
ultimate goal being to expand and share the knowledge of
cranial osteopathy.
ACKNOWLEDGEMENTS

The authors would like to thank their families, who are always by their sides, and are
always provide them strength. They also want to thank their friend Fabiola Marelli, DO,
and director of the School CRESO. Finally, they want to thank their friend Fabio
Castellini, DO.

AUTHOR DISCLOSURE STATEMENT

The authors report no conflicts of interest for this work.

REFERENCES
1. Sutherland W. The Cranial Bowl: A Treatise Relating to Cranial Articular
Mobility, Cranial Articular Lesions and Cranial Techniques. Mankato, MN: Free
Press Co; 1939.
2. Magoun HI. The application to the cranium of the principles of osteopathy,
based on the arduous study and keen clinical observation of William Garner
Sutherland. In: Magoun HI, ed. Osteopathy in the Cranial Field. Reprint ed. Fort
Worth, TX: Sutherland Cranial Teaching Foundation; 1997.
3. Jkel A, von Hauenschild P. A systematic review to evaluate the clinical benefits
of craniosacral therapy. Complement Ther Med. 2012;20(6):456-465.
4. Jkel A, von Hauenschild P. Therapeutic effects of cranial osteopathic manipulative medicine: a systematic review. J Am Osteopath Assoc. 2011;111(12):685-693.
5. Bassed RB, Briggs C, Drummer OH. Analysis of time of closure of the sphenooccipital synchondrosis using computed tomography. Forensic Sci Int.
2010;200(1-3):161-164.
6. Di Ieva A, Bruner E, Haider T, et al. Skull base embryology: a multidisciplinary
review. Childs Nerv Syst. 2014;30(6):991-1000.
7. Di Ieva A, Bruner E, Davidson J, et al. Cranial sutures: a multidisciplinary review.
Childs Nerv Syst. 2013;29(6):893-905.
8. Upledger JE, Vredevoogd JD. Craniosacral Therapy. Seattle, WA: Eastland Press;
1983.
9. Krishan K, Kanchan T. Evaluation of spheno-occipital synchondrosis: a review of
literature and considerations from forensic anthropologic point of view. J
Forensic Dent Sci. 2013;5(2):72-76.
10. Franklin D, Flavel A. Brief communication: timing of spheno-occipital closure in
modern Western Australians. Am J Phys Anthropol. 2014;153(1):132-138.
11. Shirley NR, Jantz RL. Spheno-occipital synchondrosis fusion in modern
Americans. J Forensic Sci. 2011;56(3):580-585.
12. Herring SW. Mechanical influences on suture development and patency. Front
Oral Biol. 2008;12:41-56.
13. Maloul A, Fialkov J, Whyne CM. Characterization of the bending strength of
craniofacial sutures. J Biomech. 2013;46(5):912-917.
14. Maloul A, Fialkov J, Hojjat SP, Whyne CM. A technique for the quantification of
the 3D connectivity of thin articulations in bony sutures. J Biomech.
2010;43(6):1227-1230.
15. Rogers JS, Witt PL. The controversy of cranial bone motion. J Orthop Sports Phys
Ther. 1997;26(2):95-103.
16. Skedung L, Arvidsson M, Chung JY, Stafford CM, Berglund B, Rutland MW.
Feeling small: exploring the tactile perception limits. Sci Rep. 2013;3:2617.
17. Hanten WP, Dawson DD, Iwata M, Seiden M, Whitten FG, Zink T. Craniosacral
rhythm: reliability and relationships with cardiac and respiratory rates. J Orthop
Sports Phys Ther. 1998;27(3):213-218.
18. Nelson KE, Sergueef N, Lipinski CM, Chapman AR, Glonek T. Cranial rhythmic
impulse related to the Traube-Hering-Mayer oscillation: comparing laser-Doppler flowmetry and palpation. J Am Osteopath Assoc. 2001;101(3):163-173.
19. Nelson KE, Sergueef N, Glonek T. Recording the rate of the cranial rhythmic
impulse. J Am Osteopath Assoc. 2006;106(6):337-341.
20. Whedon JM, Glassey D. Cerebrospinal fluid stasis and its clinical significance.
Altern Ther Health Med. 2009;15(3):54-60.
21. Maier SE, Hardy CJ, Jolesz FA. Brain and cerebrospinal fluid motion: real-time
quantification with M-mode MR imaging. Radiology. 1994;193(2):477-483.
22. Motherway JA, Verschueren P, Van der Perre G, Vander Sloten J, Gilchrist MD.
The mechanical properties of cranial bone: the effect of loading rate and cranial
sampling position. J Biomech. 2009;42(13):2129-2135.
23. Davis MT, Loyd AM, Shen HY, et al. The mechanical and morphological properties of 6 year-old cranial bone. J Biomech. 2012;45(15):2493-2498.
24. Kim DG, Huja SS, Navalgund A, et al. Effect of estrogen deficiency on regional
variation of a viscoelastic tissue property of bone. J Biomech. 2013;46(1):110-115.
25. Clayton EH, Genin GM, Bayly PV. Transmission, attenuation and reflection of
shear waves in the human brain. J R Soc Interface. 2012;9(76):2899-2910.

BordoniOsteopathic Cranial Model and Modern Osteopathy

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26. Hilloowala R, Kanth H. The transmission of masticatory forces and nasal septum: structural comparison of the human skull and Gothic cathedral. Cranio.
2007;25(3):166-171.
27. Papachroni KK, Karatzas DN, Papavassiliou KA, Basdra EK, Papavassiliou AG.
Mechanotransduction in osteoblast regulation and bone disease. Trends Mol
Med. 2009;15(5):208-216.
28. Harrigan TP, Roberts JC, Ward EE, Carneal CM, Merkle AC. Effect of skull flexural properties on brain response during dynamic head loadingbiomed 2013.
Biomed Sci Instrum. 2013;49:187-194.
29. Sergueef N, Nelson KE, Glonek T. Palpatory diagnosis of plagiocephaly.
Complement Ther Clin Pract. 2006;12(2):101-110.

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