Review  |   June 2020
The Role of Sphenobasilar Synchondrosis in Disease and Health
Author Notes
  • Financial Disclosures: None reported. 
  • Support: None reported. 
  •  *Address correspondence to Torsten LieMSc Ost, MSc Paed Ost, Osteopathie Schule Deutschland Mexikoring 19, 22297 Hamburg, Germany. Email:
Article Information
Review   |   June 2020
The Role of Sphenobasilar Synchondrosis in Disease and Health
The Journal of the American Osteopathic Association, June 2020, Vol. 120, 404-412. doi:
The Journal of the American Osteopathic Association, June 2020, Vol. 120, 404-412. doi:

Background: The sphenobasilar synchondrosis (SBS; also, sphenobasilar synostosis or sphenooccipital synchondrosis) plays a major role in the concept of osteopathic cranial manipulative medicine (OCMM) and craniosacral therapy. Previous research suggests that many individuals, from newborns to adults, present with single or multiple SBS strain patterns as a result of the birth process and other traumatic forces throughout life. To date, it is unclear whether specific SBS lesion patterns are present in altered health states and disease and how they compare with healthy controls.

Objective: To identify research that reports on specific SBS strain patterns compared with healthy controls.

Methods: A literature review of electronic databases and hand-search of publication bibliographies was performed. Observational studies of newborns, children, and adults were included if there was information on the occurrence of cranial strain patterns related to the SBS in individuals with impaired health states and a healthy control group.

Results: Of 1123 citations, 836 articles were screened after duplicate removal, and 42 articles were evaluated by full-text assessment. Three articles were included in this review, including 1 prospective and 2 retrospective studies. The age ranges of the populations studied were newborns aged 5 days or younger, children aged 4 to 14 years, and adults aged 45 to 90 years. In adults with Parkinson disease, no significant difference in SBS strain patterns between the Parkinson disease group and the age-matched healthy control group were seen. In contrast, different SBS strain patterns were observed between newborns with a range of health impairments, such as jaundice and respiratory and nervous symptoms, and children with learning disabilities compared with their healthy counterparts. However, no statistical analysis was conducted in these 2 studies; hence, results are difficult to interpret. Reporting in all 3 studies was limited; therefore, the methodologic quality of the 3 identified studies was deemed incapable of being judged.

Conclusion: The study landscape of this review highlights the scarcity of, poor reporting on, and unclear methodologic quality of research on SBS strain patterns in disease and health. It is still unclear whether and to what extent specific SBS strain patterns occur in impaired health states compared with healthy controls. Future studies should seek to improve study methods and reporting and minimize the risk of bias.

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