CT of the main ligaments of the cervico-occipital hinge

Burguet, Jean-Louis; Sick, H; Dirheimer, Yves; Wackenheim, A

doi:10.1007/bf00343780

Cited by 24 publications

(9 citation statements)

References 6 publications

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“…Absence of the tip of the dens (Morquio's syndrome) is rare but may result in separation of the remaining dens from the anterior arch of the atlas and impingement into the vertebral canal below the foramen magnum since the transverso-dental joint is nonfunctional or nonexistent (Burguet, et al, 1985). Laxity of the transverse ligament and instability of the transverso-dental joint occurs in Down syndrome (Siegfried and Scola, 1987) and in rheumatoid arthritis (Menezes et al, 1985;Reynolds et al, 1987); on the other hand the transverse ligament may be ossified in acromegaly (Burguet et al, 1985). Complete separation of the dens from the body of the axis (0s odontoideum) is rare and usually the result of trauma (Ogden, 1988).…”

Section: Discussionmentioning

confidence: 98%

Imaging anatomy of the cranio‐vertebral junction (occipito‐atlanto‐axial joint)

Engelman¹,

Schnitzlein²,

Hilbelink³

et al. 1989

Clinical Anatomy

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The diagnostic value of magnetic resonance imaging (MRI) is directly related to the ability to interpret differences between significant pathology and normal anatomical variations. A multidisciplinary investigation of the cranio-vertebral articulation with CT, MRI, anatomical dissections and sections, 3D reconstruction, and injections of contrast into the joint spaces has demonstrated some of the anatomical structures which can cause differences in CT and MR images. Some of the factors which can contribute to variations observed in clinical imaging include the supraodontoid bursa with varying amounts of fat or containing a Bergmann's ossicle, fat pads related to the transverse ligament or laxity of the ligament, identification of the ossiculum terminale or of the synostosis at the base of the dens, and flow patterns in the vertebral plexus of veins.

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Section: Discussionmentioning

confidence: 98%

Imaging anatomy of the cranio‐vertebral junction (occipito‐atlanto‐axial joint)

Engelman¹,

Schnitzlein²,

Hilbelink³

et al. 1989

Clinical Anatomy

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“…The thickness of the ligament seems to vary between 2 and 3 mm (Burguet et al, 1985;Okazaki, 1995;Ebraheim et al, 1998;Krakenes et al, 2001). The length of the transverse ligament is *20 mm (Okazaki, 1995;Panjabi et al, 1998).…”

Section: Introductionmentioning

confidence: 95%

“…The transverse ligament of the atlas emerges from the left and right tubercles of the lateral mass of the atlas and runs posterior to the dens axis (Burguet et al, 1985;Tubbs et al, 2002). The thickness of the ligament seems to vary between 2 and 3 mm (Burguet et al, 1985;Okazaki, 1995;Ebraheim et al, 1998;Krakenes et al, 2001).…”

Section: Introductionmentioning

confidence: 97%

“…Classical textbooks usually describe the insertion on the dens but many are vague in their description about the exact insertion on the occiput. Some authors indicate that the cranial insertion is on the anterolateral aspect of the foramen magnum (Burguet et al, 1985;Dvorak and Panjabi, 1987) while others indicate more precisely that it is situated on the medial, rough aspect of the occipital condyles (Krakenes et al, 2001).…”

Section: Introductionmentioning

confidence: 98%

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3D morphometry of the transverse and alar ligaments in the occipito–atlanto–axial complex: An in vitro analysis

et al. 2007

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This study verifies the three-dimensional anatomical features of the transverse and alar ligaments with reference to the axis using a direct in vitro approach. In 20 fresh spine specimens, metal markers were inserted on the cranium, atlas, and axis. After registration of the intact specimen, the bony segments were separated, and markers and anatomical landmarks were digitized. The length and the orientation of the ligaments with reference to the axis were derived from the relative position data. The transverse ligaments of the atlas have a mean estimated length of 21 mm and an absolute angle (i.e., independent of any reference frame) of 119 degrees +/- 17 degrees . The alar ligaments have a mean length of 9 +/- 2.5 mm, and the mean absolute angle between the ligaments is 117 degrees +/- 31 degrees . The plane of the alar ligaments shows a mean backward inclination of -10 degrees +/- 52 degrees . This plane has a mean inclination of 6 degrees +/- 4 degrees with reference to the sagittal plane indicating left-right symmetries. The transverse ligament arches around the dens and demonstrating its function as a stabilizer for the dens as well as guidance for axial rotation movements. A posterior inclination of the alar ligaments may induce a coupled extension in combination with a lateral bending during axial rotation. These detailed aspects of motion steering may be important to consider when attempting to reduce or restore movement.

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“…This presented as prominence of soft tissue in the region of the cruciate ligament. An anteroposterior measurement greater than 3 mm is considered abnormal [12].…”

Section: Methodsmentioning

confidence: 99%

Magnetic Resonance Imaging of Pseudotumors of the Craniovertebral Junction in Long-Term Hemodialysis Patients

et al. 1999

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Background/Aims: Pseudotumors of the craniovertebral junction (PTCVJ) are observed in long-term hemodialysis (HD) patients. There are neither criteria for diagnosis nor guidelines for screening. We attempted to determine magnetic resonance imaging (MRI) findings that could be used to detect PTCVJ, to determine the prevalence of PTCVJ, and to evaluate whether destructive spondyloarthropathy (DSA) might be a yardstick for selection of patients for MRI examination for PTCVJ. Methods: MRI were examined in 19 DSA patients (8 males, 11 females, age 61.4 ± 7.3 years, HD duration 17.0 ± 4.4 years) and in 20 sex-, age-, and HD-duration-matched non-DSA patients (9 males, 11 females, age 57.5 ± 6.6 years, HD duration 17.7 ± 4.9 years). We evaluated MRI characteristics of PTCVJ according those which occur due to rheumatoid arthritis. Results: PTCVJ were characterized as follows: disappearance of fat pads in the upper region (supradental PTCVJ), intensity change of the ‘predental triangle’ in the anterior region (predental PTCVJ), and thickening of cruciform ligaments (retrodental PTCVJ). The prevalence of PTCVJ among patients undergoing HD more than 10 years was high (26 out of 39; 66.7%). The prevalence of PTCVJ was not different between DSA and non-DSA groups. Conclusion: We verified that the above MRI findings might be helpful in the detection of PTCVJ. These findings were observed frequently and independently also in patients with DSA.

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CT of the main ligaments of the cervico-occipital hinge

Cited by 24 publications

References 6 publications

Imaging anatomy of the cranio‐vertebral junction (occipito‐atlanto‐axial joint)

Imaging anatomy of the cranio‐vertebral junction (occipito‐atlanto‐axial joint)

3D morphometry of the transverse and alar ligaments in the occipito–atlanto–axial complex: An in vitro analysis

Magnetic Resonance Imaging of Pseudotumors of the Craniovertebral Junction in Long-Term Hemodialysis Patients

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