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Ligaments of the Atlantoaxial Joint

Surgical Correlation


Ligaments of the Atlantoaxial Joint. The dens (odontoid process) is a bony projection from the body of the axis vertebra that extends superiorly into the vertebral foramen of the atlas. It is held firmly in place against the posterior surface of the anterior arch of the atlas by the transverse ligament of the atlas. This ligament attaches bilaterally to the medial aspect of the lateral masses of C1. A pair of strong alar ligaments connect the upper lateral edges of the dens to the corresponding margins of the foramen magnum. The alar and transverse ligaments serve as the principal stabilizers of the median atlantoaxial joint. Extending superiorly and inferiorly from the transverse ligament are, respective, superior and inferior longitudinal bands to the clivus and body of the axis. These bands are weak. These bands, with the transverse ligament, form the parts of the cruciate (or cruciform) ligament of the atlas. A portion of the atlantic part of the left vertebral artery lays on the upper surface of the posterior arch of the atlas. Stumps of the spinal accessory (CNXI) and hypoglossal (CNXII) nerves are also in view.  (Image courtesy of PA Rubino)