Spenobasilar Lesions and Sutherland Techniques

Question 1

What percentage of the sphenoid lesion patterns are caused by sphenobasilar comp/decomp and are relieved by compression/decompression treatment?

Answer 1

85%-90% of sphenobasilar dysfunctions are caused by and/or addressed by compression/decompression.

Question 2

What is the axis of a sidebending lesion?

How would you treat/evaluate for sidebend lesion?

Answer 2

A Sidebending lesion has a Vertical or longitudinal axis.

stabilize the occiput, rotate the right wing of the sphenoid anteriorly, left wing posteriorly, etc.

Question 3

Clinical Significance of Torsion Lesion

Answer 3

Head, Neck, Back pain, Scoliosis, sacrum mimics occiput, eye motion problems, temporal bone dysfunction

Question 4

List The Sutherland Sphenoid Lesions from least to greatest clinical severity:

Answer 4

Flexion Lesion, 
Extension Lesion, 
Torsion Lesion (R/L), 
Sidebend Lesion (R/L), 
Lateral Strain Lesion (R/L), 
Vertical Strain Lesion and 
Compression Lesion

Question 5

Who was Dr. Sutherland and what is the Sutherland method or model?

Answer 5

Dr. Sutherland was a pioneer of cranial osteopathy in the early- to mid-1900’s. He was a student of Dr. Andrew Taylor Still.

He identified restriction patterns of the sphenobasilar area of the cranial base and developed corresponding evaluation and treatment methods.

Question 6

How was Dr. Sutherland’s hypothesis of the sphenobasilar restrictions different from Dr. Upledger’s?

Answer 6

Dr. Sutherland hypothesized that the restrictions were primarily osseus in nature and worked on the assumption that the sphenobasilar joint was a symphysis.

Later research revealed that the sphenobasilar joint is a synchondrosis, which does not allow for some of the motions of the lesions that Dr. Sutherland attributed to the symphysis.

Dr. Upledger: these restrictions are “abnormal membrane and soft tissue tensions and sutural restrictions”.

Question 7

Is the sphenobasilar joint a synchondrosis?

Answer 7

Yes, the sphenobasilar joint is a synchondrosis.

Question 8

What does lesion mean in cranial osteopathy?

Answer 8

“Lesion” describes a dysfunctional pattern, or restriction pattern where the area is not able to be at normal positioning, mobility or ease.

Question 9

Are the Sutherland restriction patterns or Lesions named for direction of ease or direction of barrier?

Answer 9

He named them for their direction of ease or greatest range of motion when tested.

Question 10

What is the axis for flexion/extension lesion evaluation?

Answer 10

Transverse axis

inferior/superior motion of the sphenoid, no need to stabilize the occiput

Question 11

What does lesion Origin of Dysfunction “compensatory” vs. “non-compensatory” mean?

Answer 11

Compensatory means origin of lesion is external to craniosacral system.

Non-compensatory means origin of lesion is internal to craniosacral system, or originated within the CSS.

Question 12

Name the direction of rotation of sphenoid to occiput for each of the Sutherland SB lesions:

Answer 12

opposite:
flexion/extension, torsion, sidebend

same:
lateral strain, vertical strain

none:
compression

Question 13

Name physiological vs. non-physiological motion in the Sutherland sphenobasilar lesions:

Answer 13

Flexion and Extension: physiological motion

Torsion, Sidebend, Lateral, Vertical: non-physiological motion

Compression: non-physiological position

Must stabilize the occiput while treating or evaluating non-physiological motion of sphenoid

Question 14

Name the Origin of Dysfunction “compensatory” vs. “non-compensatory” for each Sutherland SB lesion pattern:

Answer 14

Compensatory (external to CSS): flexion/extension, sidebend, torsion

Non-compensatory (internal to CSS): lateral strain, vertical strain, compression

Question 15

What is the clinical significance of a flexion lesion?

Answer 15

Flexion Lesion complaints tend to be recurring sinus issues, endocrine dysfunction, musculoskeletal pain, headaches, pelvic and lumbosacral instability.

Question 16

What is the clinical significance of an extension lesion?

Answer 16

Extension Lesion issues may express as migraines, sinusitis, obsessive/compulsive, musculoskeletal pain, can be self-treated by solitary exercise.

Question 17

What is the axis of rotation for Torsion lesion?

How would you treat or evaluate for torsion?

Answer 17

anterior/posterior or frontal axis

rotate the sphenoid left wing superior, right wing inferior, etc. while stabilizing the occiput

Question 18

What is the axis of rotation for lateral strain lesion?

Answer 18

vertical or longitudinal axis

similar to sidebend
while moving sphenoid laterally, same side may move anterior

Question 19

What is the axis of rotation for vertical strain lesion?

Answer 19

transverse
(similar to flexion/extension)
check by moving sphenoid inferior/superior

Question 20

Clinical significance of sidebend lesion?

Answer 20

Sidebend Lesions tend towards musculoskeletal pain syndromes, headache, endocrine disorders, visual perception and motor disturbances, sinusitis, nasal and upper respiratory allergies, temporomandibular joint problems, dental malocclusion and scoliosis.

Question 21

Clinical Significance of lateral strain lesion?

Answer 21

Lateral Strain Lesions are often the result of birth head trauma, direct blow to the head, sacral concussion. As the source injury is primary to the craniosacral system, the symptoms are more severe than the previous lesions.

Symptoms include dysfunction of eye movement, strabismus, reading problems, severe head pain, personality disorders, increased spasticity in cerebral palsy, whole body pain syndromes, learning disabilities and endocrine disorders.

Question 22

Clinical Significance of Vertical strain lesion?

Answer 22

The origin of the injury may be a direct blow to the head or birth trauma, sacral compression, etc.

The symptoms are similar to but more severe than Lateral Strain Lesions. This lesion is associated with severe head pain, eye motor issues, sinusitis, allergies, personality disorders with violent outbursts and antisocial acts, whole body pain syndromes and endocrine disorders.

Question 23

Clinical Significance of Compression lesion?

Answer 23

The origin of the Cranial Base Compression dysfunction is primary to the craniosacral system, intracranial dura mater, sutures, occipital condyle and L5-S1.

This non-compensatory, non-physiological lesion is the most severe of the sphenobasilar lesions.

Symptoms can manifest as depression, sciatica, autism, allergies and severe emotional problems.

Question 24

How does one treat Compression lesion?

Answer 24

Stabilize the occiput.

Decompress wings of sphenoid in the anterior direction.

Question 25

What is the V-Spread?
Who developed it?
How is it useful?

Answer 25

Dr Sutherland developed the V-Spread.
The V-Spread is particularly useful for a specific release like a suture, as it can line up directly along the treatment area.

To perform the V-Spread, use one hand to make a V with two of the fingers spread apart. Place the V fingers lightly on either side of the restricted cranial suture, with the other hand opposite to or otherwise associated with the restricted suture. The non-V-shaped hand can have one or more fingers pointed and aimed through the tissues towards the center of the V at the restricted suture. Send energy from the non-V-shaped hand through the head, aimed for the suture and the space between the fingers of the V. The energy can be sent until there is a softening and a therapeutic pulse at the restriction site. The release is complete when there is no longer a feeling of a rigid or hard barrier.