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Posterolateral View of the Craniovertebral Junction

Surgical Correlation

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Posterolateral view of the craniovertebral junction.  A portion of the occipital bone has been removed to expose the dura overlying the cerebellum.  A remnant of the tectorial membrane is visible above the C1 vertebra.  This membrane is the extension of the posterior longitudinal ligament that passes superiorly through foramen magnum to attach to the internal surface of the occipital bone.  The posterior aspects of the C1 and C2 vertebrae have been exposed.  C1 is unique in that it lacks a spinous process; instead it has a small posterior tubercle.  A segment of the ligamenta flava is visible between the posterior arch of C1 and the lamina of C2.  The atlantic part of the vertebral artery is visible coursing through the transverse foramina of C2 and C1 before turning medially to course within a groove on the posterior arch of the atlas.  The posterior meningeal branch of the vertebral artery supplies the dura of the posterior cranial fossa and the falx cerebelli.  The C2 spinal nerve emerges between the C1 and C2 vertebrae.  The dorsal root ganglion contains cell bodies of sensory neurons associated with this nerve.  Just distal to the ganglion the C2 spinal nerve branches into dorsal and ventral rami. (Image courtesy of PA Rubino)

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