The Accessory Atlantoaxial Ligament

Neurosurgery ◽  
2004 ◽  
Vol 55 (2) ◽  
pp. 400-404 ◽  
Author(s):  
R. Shane Tubbs ◽  
E. George Salter ◽  
W. Jerry Oakes
Keyword(s):  
Cervical Spine ◽  
Imaging Techniques ◽  
Upper Cervical Spine ◽  
Spine Trauma ◽  
Resonance Imaging ◽  
Alar Ligament ◽  
Upper Cervical ◽  
Magnetic Resonance Imaging Techniques ◽  
The Stability ◽  
Accessory Atlantoaxial Ligament

Abstract OBJECTIVE: The stability of the joints connecting the cranium to the upper cervical spine is of vital importance. The ligaments of this region, for the most part, have been thoroughly investigated, with the exception of the accessory atlantoaxial ligament. METHODS: Ten cadaveric specimens were examined to observe the anatomy of this ligament. RESULTS: This ligament was found in all specimens, and in each, it not only connected the atlas to the axis but also continued cephalically to the occipital bone. The approximate dimensions of this structure were 3 cm ×5 mm. Functionally, this ligament became maximally taut with a rotation of the head of 5 to 8 degrees. Laxity was observed with cervical extension, and maximal tautness was seen at 5 to 10 degrees of cervical flexion. CONCLUSION: The accessory atlantoaxial ligament seems to participate in craniocervical stability and perhaps should be renamed the accessory alar ligament or accessory atlantoaxialoccipital ligament; both of these terms better denote its anatomic characteristics. Perhaps in the future, better magnetic resonance imaging techniques and machines will be able to identify this structure so as to appreciate its integrity after upper cervical spine trauma.

scholarly journals Normal kinematics of the upper cervical spine during the Flexion–Rotation Test – In vivo measurements using magnetic resonance imaging

2011 ◽  
Vol 16 (2) ◽  
pp. 167-171 ◽  
Author(s):  
Hiroshi Takasaki ◽  
Toby Hall ◽  
Sadanori Oshiro ◽  
Shouta Kaneko ◽  
Yoshikazu Ikemoto ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Cervical Spine ◽  
Magnetic Resonance ◽  
Upper Cervical Spine ◽  
Resonance Imaging ◽  
Rotation Test ◽  
In Vivo Measurements ◽  
Upper Cervical

Upper cervical spine trauma

1997 ◽  
Vol 47 (5) ◽  
pp. 432-433
Author(s):  
Hyong Chun Park ◽  
Kyu Chang Lee
Keyword(s):  
Cervical Spine ◽  
Upper Cervical Spine ◽  
Cervical Spine Trauma ◽  
Spine Trauma ◽  
Upper Cervical

scholarly journals In Vitro Upper Cervical Spine Kinematics: Rotation with Combined Movements and its Variation After Alar Ligament Transection

2021 ◽  
pp. 110872
Author(s):  
Ana I. LORENTE ◽  
César HIDALGO-GARCÍA ◽  
Pablo FANLO-MAZAS ◽  
Jacobo RODRÍGUEZ-SANZ ◽  
Carlos LÓPEZ-de-CELIS ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Upper Cervical Spine ◽  
Alar Ligament ◽  
Spine Kinematics ◽  
Upper Cervical ◽  
Combined Movements

Numerical investigation on the stability of human upper cervical spine (C1–C3)

2021 ◽  
pp. 1-13
Author(s):  
Waseem Ur Rahman ◽  
Wei Jiang ◽  
Guohua Wang ◽  
Zhijun Li
Keyword(s):  
Finite Element ◽  
Cervical Spine ◽  
Axial Rotation ◽  
Upper Cervical Spine ◽  
Fe Model ◽  
Facet Joints ◽  
Flexion Extension ◽  
Upper Cervical ◽  
The Stability

BACKGROUND: The finite element method (FEM) is an efficient and powerful tool for studying human spine biomechanics. OBJECTIVE: In this study, a detailed asymmetric three-dimensional (3D) finite element (FE) model of the upper cervical spine was developed from the computed tomography (CT) scan data to analyze the effect of ligaments and facet joints on the stability of the upper cervical spine. METHODS: A 3D FE model was validated against data obtained from previously published works, which were performed in vitro and FE analysis of vertebrae under three types of loads, i.e. flexion/extension, axial rotation, and lateral bending. RESULTS: The results show that the range of motion of segment C1–C2 is more flexible than that of segment C2–C3. Moreover, the results from the FE model were used to compute stresses on the ligaments and facet joints of the upper cervical spine during physiological moments. CONCLUSION: The anterior longitudinal ligaments (ALL) and interspinous ligaments (ISL) are found to be the most active ligaments, and the maximum stress distribution is appear on the vertebra C3 superior facet surface under both extension and flexion moments.

scholarly journals Dynamic Kine Magnetic Resonance Imaging in Whiplash Patients and in Age- and Sex-Matched Controls

2009 ◽  
Vol 14 (6) ◽  
pp. 427-432 ◽  
Author(s):  
Karl-August Lindgren ◽  
Jyrki A Kettunen ◽  
Markku Paatelma ◽  
Raija HM Mikkonen
Keyword(s):  
Magnetic Resonance Imaging ◽  
Cervical Spine ◽  
Magnetic Resonance ◽  
Proton Density ◽  
Upper Cervical Spine ◽  
Resonance Imaging ◽  
Motion Patterns ◽  
Alar Ligaments ◽  
Abnormal Movements ◽  
Upper Cervical

The multitude of symptoms following a whiplash injury has given rise to much discussion because of the lack of objective radiological findings. The ligaments that stabilize the upper cervical spine can be injured. Dynamic kine magnetic resonance imaging (dMRI) may reveal the pathological motion patterns caused by injury to these ligaments. To compare the findings and motion patterns in the upper cervical spine, 25 whiplash trauma patients with longstanding pain, limb symptoms and loss of balance indicating a problem at the level of C0–C2, as well as matched healthy controls were imaged using dMRI. Imaging was performed with an Intera 1.5 T (Philips Healthcare, USA) magnet. A physiotherapist performed the bending and rotation of the upper cervical spine for the subjects to ensure that the movements were limited to the C0–C2 level. An oblique coronal T2- and proton density-weighted sequence and a balanced fast field echo axial sequence were used. The movements between C0–C2 and the signal from the alar ligaments were analyzed. Contact of the transverse ligament and the medulla in rotation was seen in two patients. The signal from the alar ligaments was abnormal in 92% of the patients and in 24% of the control subjects (P<0.0001). Abnormal movements at the level of C1–C2 were more common in patients than in controls (56% versus 20%, P=0.028). Whiplash patients with longstanding symptoms had both more abnormal signals from the alar ligaments and more abnormal movements on dMRI at the C0–C2 level than controls.

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