Alar + Transverse Ligament Injury

    Cards (12)

    • the alar + transverse ligament stabilize the head on the neck
    • injury to the alar or transverse ligaments can result in instability + risk compromise of the brainstem + spinal cord
    • the upper cervical spine (C0-3) lack the articular stablity of the segments below
    • passive structures (alar + transverse lig) are largely responsible for the stability of the upper cervical region
    • the transverse ligament is stronger than the alar ligament
    • transverse ligament function:
      • prevent anterior to posterior sliding of the head on the neck with cervical flexion + extension
    • rupture of the transverse ligament allows the head to slide forward on the neck with cervical flexion --> causes entrapment of the brainstem + can result in spinal cord damage
    • a force of about 85 kg is required to rupture the transverse ligament
    • both alar ligaments must be ruptured before dislocation of the C1/2 segment is possible
    • cervical spine subluxations are observed in 43-86% of patients who have RA + occur more in men
    • OA subluxations occur in up to 39% of patients with RA
    • common signs + symptoms of transverse + alar ligament injury:
      • hesitancy to move head or neck in any direction
      • when moving head, may experience:
      • diplopia
      • dysarthria
      • dysphasia
      • dizziness
      • drop attacks
      • tinnitus
      • HA
      • blurry vision
      • nausea
      • lump in throat
      • difficulty concentrating
      • bilateral paresthesias in hand or feet
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