Mechanism of Craniovertebral Ligamentous System Injuries and Their Effect on Spinal Arteries Blood Flow (Experimental Study)

2004 ◽  
Vol 11 (3) ◽  
pp. 30
Author(s):  
S. V Kolesov
Keyword(s):  
Blood Flow ◽  
Cervical Spine ◽  
Dynamic Compression ◽  
Ligament Injury ◽  
Upper Cervical Spine ◽  
Transverse Ligament ◽  
Alar Ligament ◽  
Alar Ligaments ◽  
Upper Cervical ◽  
Unilateral Injury

In 22 anatomic preparations of the cervical spine block various injuries of the ligamentous system were simulated and the evaluation of their effect upon the spinal arteries blood flow was per­formed. It has been shown that within craniovertebral segment the alar and transverse ligaments play the basic stabilizing role. Bending rotative, straightening rotative and bending mechanisms of injury may cause different volume of ligamentous system injuries. Three types of injuries have been detected: unilateral injury of the alar ligament, unilateral injury of the alar injury in combination with the transverse ligament injury and bilateral injury of the alar ligaments in combination with the transverse ligament injury. Injury of the upper cervical spine ligamentous structures results in the development of spine instability; especially in instability of atlantoaxial junction that causes dynamic compression of spinal arteries at atlantoaxial segment rotation.

scholarly journals Rheumatoid Arthritis Affecting the Upper Cervical Spine: Biomechanical Assessment of the Stabilizing Ligaments

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Carolin Meyer ◽  
Jan Bredow ◽  
Elisa Heising ◽  
Peer Eysel ◽  
Lars Peter Müller ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Cervical Spine ◽  
Neurological Disorders ◽  
Cord Compression ◽  
Upper Cervical Spine ◽  
Neutral Position ◽  
Transverse Ligament ◽  
Alar Ligaments ◽  
Upper Cervical

Diameters of anterior and posterior atlantodental intervals (AADI and PADI) are diagnostically conclusive regarding ongoing neurological disorders in rheumatoid arthritis. MRI and X-ray are mostly used for patients’ follow-up. This investigation aimed at analyzing these intervals during motion of cervical spine, when transverse and alar ligaments are damaged. AADI and PADI of 10 native, human cervical spines were measured using lateral fluoroscopy, while the spines were assessed in neutral position first, in maximal inclination second, and in maximal extension at last. First, specimens were evaluated under intact conditions, followed by analysis after transverse and alar ligaments were destroyed. Damage of the transverse ligament leads to an increase of the AADI’s diameter about 0.65 mm in flexion and damage of alar ligaments results in significant enhancement of 3.59 mm at mean. In extension, the AADI rises 0.60 mm after the transverse ligament was cut and 0.90 mm when the alar ligaments are damaged. After all ligaments are destroyed, AADI assessed in extension closely resembles AADI at neutral position. Ligamentous damage showed an average significant decrease of the PADI of 1.37 mm in the first step and of 3.57 mm in the second step in flexion, while it is reduced about 1.61 mm and 0.41 mm in the extended and similarly in the neutrally positioned spine. Alar and transverse ligaments are both of obvious importance in order to prevent AAS and movement-related spinal cord compression. Functional imaging is necessary at follow-up in order to identify patients having an advanced risk of neurological disorders.

Atlantal fracture with transverse ligament disruption in a child

2009 ◽  
Vol 4 (3) ◽  
pp. 196-198 ◽  
Author(s):  
Marcelo D. Vilela ◽  
Eric C. Peterson
Keyword(s):  
Cervical Spine ◽  
Surgical Treatment ◽  
Upper Cervical Spine ◽  
Transverse Ligament ◽  
Jefferson Fracture ◽  
Fractures In Children ◽  
Upper Cervical ◽  
Almost All ◽  
Ligament Disruption

Even though fractures in children with immature spines occur predominantly in the upper cervical spine, isolated C-1 fractures are relatively rare. The fractures in almost all cases reported to date were considered stable due to the presence of the intact transverse ligament. The authors report the case of a young child who sustained a Jefferson fracture and in whom MR imaging revealed disruption of the transverse ligament. Although surgical treatment has been suggested as the treatment of choice for children with unstable atlantoaxial injuries, external immobilization alone allowed a full recovery in the patient with no evidence of instability at follow-up.

Spinal Posture Affects Whiplash Biomechanics

2003 ◽  
Author(s):  
Brian D. Stemper ◽  
Narayan Yoganandan ◽  
Frank A. Pintar
Keyword(s):  
Cervical Spine ◽  
Whiplash Injury ◽  
Facet Joint ◽  
Ligament Injury ◽  
Upper Cervical Spine ◽  
Anterior Longitudinal Ligament ◽  
Spinal Posture ◽  
Male Head ◽  
Upper Cervical ◽  
Cervical Facet

The present study implemented the MADYMO 50th percentile male head-neck model to investigate effects of initial spinal posture on cervical spine kinematics in whiplash. The model was altered to three initial postures: lordosis, straight, kyphosis. The three models were exercised under 2.6 m/sec rear impact pulses. Segmental kinematics and ligament strains were investigated during cervical S-curvature and throughout the whiplash event. Anterior longitudinal ligament strains during S-curvature varied from 20 to 47% of maximum strains. Facet joint strains during S-curvature were 42 to 100% of maximum strains. This finding indicates that facet joint ligaments are more susceptible to whiplash injury during S-curvature, while anterior longitudinal ligament injury likely occurs during the extension phase. Kyphosis and straight postures increased anterior longitudinal ligament strains in the upper cervical spine from the lordosis posture. Lower cervical facet joint and anterior longitudinal ligament strains were greater in the lordosis posture. This study shows that spinal posture may affect injury mechanisms and render a specific population more susceptible to whiplash injury.

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

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.

A model of the alar ligaments of the upper cervical spine in axial rotation

1991 ◽  
Vol 24 (7) ◽  
pp. 607-614 ◽  
Author(s):  
Joseph J. Crisco ◽  
Manohar M. Panjabi ◽  
Jiri Dvorak
Keyword(s):  
Cervical Spine ◽  
Axial Rotation ◽  
Upper Cervical Spine ◽  
Alar Ligaments ◽  
Upper Cervical

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.

Effects of Alar ligament transection on upper cervical spine rotation

1991 ◽  
Vol 9 (4) ◽  
pp. 584-593 ◽  
Author(s):  
Manohar Panjabi ◽  
Jiri Dvorak ◽  
Joseph John Crisco ◽  
Takenori Oda ◽  
Ping Wang ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Upper Cervical Spine ◽  
Alar Ligament ◽  
Upper Cervical
Sign in / Sign up

Export Citation Format

Share Document