Atlas Fractures & Transverse Ligament Injuries are traumatic injuries usually caused by high-energy trauma with axial loading in young patients (Jefferson Fracture) or low-energy falls in elderly. (2008) shows the Transverse Ligament Stress test has a diagnostic accuracy of sensitivity 65%, the specificity of 99%, predictive values 0.97, and positive likelihood ratios of 51.44 and negative likelihood ratio of 0.35. View Media Gallery AAI is defined as an atlantodental (or atlantodens or atlas-dens) interval (ADI) of greater than 3 mm in adults and of greater than 5 mm in children as measured on plain radiography. They therefore permit freedom of movement within a certain limited range while holding the attached bones . Verification of a relationship of dens axis, atlas and occipital condyles. Transverse ligament The transverse ligament of the atlas (TLA), or transverse portion of the cruciform ligament, has been called the most important ligament of the occiput-C1-C2 complex of joints (White & Panjabi, 1990 ). foramen of the transverse process. . The posterior arch of the atlas was absent and there was thickening of the transverse ligament. , OTLA . A 76-year-old female suffered from a transverse type myelopathy was successfully treated by posterior decompression. The transverse ligament of the atlas (Ligamentum transversum atlantis) is a strong transversal fibrous strip, completely independent from the dens of the axis, that it crosses dorsally. This fibrous and strong band crosses the ring of the atlas and attaches to the odontoid process. The transverse ligament limits the motion of the 1st Cervical Vertebrae (Atlas) and the 2nd Cervical Vertebrae (Axis). Contents 1 Function It is called the spinal canal and it contains the spinal cord, spinal nerves, and membranes. Figure 1 (a) Lateral radiograph showing moderately displaced odontoid fracture. It is well known that Whiplash Associated Disorders (WAD) caused by a motor vehicle collision, can produce a strain or sprain to neck muscles, ligaments and joints. The CT scan is the most sensitive method to detect it. (b and c) T2-weighted sagittal and axial MRI scans with no evidence of TAL injury Figure 2 Preoperative CT scan showing fracture pattern Surgical intervention Atlas Published 19 Sept 2011 Abstract A case of ossification of transverse ligament of atlas (TLA) is reported. It goes from one side to the other of the ventral arc of the atlas, on which it attaches. The MRI was performed an average of six years after the collision. The [ 5] A possible etiological cause in our patient could not be recognized. It is relatively weak and hence does not contribute any significant stability. Ossification of transverse ligament. The presence of calcifications of the transverse ligament of the atlas in patients with chondrocalcinosis occurs more frequently than that reported earlier. Dynamic lateral plain radiographs showed irreducible atlantoaxial subluxation (AAS). The transverse ligament divides the ring of the atlas into two unequal parts: of these, the . Ossification of the atlantal ligament may be due to calcium phosphate metabolic disease, obesity, diabetes mellitus, aging, and dynamic factors such as trauma. Enroll in our online course: http://bit.ly/PTMSK GET OUR ASSESSMENT BOOK http://bit.ly/GETPT DOWNLOAD OUR APP: iPhone/iPad: https://goo.gl/eUuF7w. The transverse ligament is the primary stabilizing component of C-1. Os odontoideum is a small oval or round shaped bone fragment observed as the most common congenital anomaly of the odontoid process. The transverse ligament is the primary stabilizer that prevents abnormal anterior translation of C1 on C2 (Yoganandan et al., 2001 ). At the cervical region the . . Transverse ligament holds dens against anterior arch of atlas. Taking into account that calcifications of TLA may manifest as CDS in a high percentage of these patients, such possibility should be . The former is attached to the basilar part of the occipital bone, in close relation with the membrana tectoria; the latter is fixed to the posterior surface of the body of the axis; hence, the whole ligament is named the cruciate ligament of the atlas. [ 8, 9] High amounts of fluoride have also been suggested as a possible cause by Wang et al. Since it causes a slowly increasing mobility or instability in. vet-Anatomy the interactive atlas of veterinary anatomy. ligament (lgmnt), strong band of white fibrous connective tissue that joins bones to other bones or to cartilage in the joint areas. The transverse ligament runs across the inner aspect of the ante- rior arch of the atlas (Cl) (Figure 1). In anatomy, the transverse ligament of the atlas is a ligament which arches across the ring of the atlas (the topmost cervical vertebra, which directly supports the skull ), and keeps the odontoid process in contact with the atlas. A case of ossification of transverse ligament of atlas (TLA) is reported. the alar and transverse ligaments are important stabilizers at the craniovertebral junctionthe alar ligaments prevent excessive rotation and lateral flexion and the transverse ligament prevents anterior dislocation of atlas on axis during flexion. 6 ) and can be visualized on axial T1-weighted MR imaging and axial CT.Posterior to the dens, the dura, tectorial membrane, and vertical part of the cruciform ligament are imaged as a single vertical band of low signal intensity on sagittal T1-weighted MR imaging (see . The total information given in Chapter 38 amounts to a "mini-textbook-cum color atlas" of gynecology. 1 - 3 these ligaments can show high signal intensity on proton attenuation-weighted high-resolution - Discussion: - rupture of transverse ligament is destabilizing injury that can occur in isolation or with atlantoaxial subluxation or an atlas fracture; - transverse ligament is primary restraint to anterior translation of atlas in relation to the lower cervical spine; - transverse lig can fail in midsubstance or . Figure 1 Multidetector-computed tomography coronary construction. Purpose To determine (a) the prevalence of atlantoaxial calcium pyrophosphate dihydrate (CPPD) crystal deposition in a population of patients undergoing computed tomography (CT) for acute trauma and (b) the association between atlantoaxial CPPD crystal deposition and retro-odontoid soft-tissue thickness. 2 . Vertebrae in Physiology of bone called the body, located anterior to the remaining transverse ligament to.. > anatomy: . The transverse ligament appears as an oval area of signal void, posterior to the upper dens, on sagittal MR imaging (see Fig. If the transverse ligament is damaged or is loose due to degeneration or genetic disorders, upper cervical instability can ensue. Furthermore, with a C1 fracture, associations exist with unstable injuries such as odontoid fractures and other injuries to the upper cervical spine. The main function of the cervical vertebrae is to protect your spinal cord. The patient underwent cervical laminectomy of the hypoplastic posterior . cervical spine neck pain vertebrae anatomy radiculopathy causes chronic cause problems there vertebral discs causing upper definition condition number through. It is firmly attached on. Eight measurements were performed per subject. (ossification of the transverse ligament of the atlas; OTLA) 1978 (1,2,3), . Contents 1 Anatomy 2 Role in disease 3 See also 4 References Anatomy [ edit] 1 Offiah C, Day E. While the transverse ligament is discernible in nearly all cases using MRI[12,13] with the ligament appearing as a relatively homogeneous low-signal intensity structure, differentiation of the margins of the ligament is often less clear due to the presence of other . Of or relating to the uterine cervix. MRI of the Transverse Ligament one with 3 years of experience in radiology and one with 6 months of training reading MRI. , MRI . A similar situation is evident in the examination of the transverse ligament. A 76-year-old female suffered from a transverse type myelopathy was successfully treated by posterior decompression. An atlantooccipital dislocation or disruption and C1-2 instability, particularly that in which the transverse ligament may be disrupted, poses severe risk to the brain stem and upper spinal cord. Its function is to hold the odontoid in place and to prevent posterior translation of the odontoid during cervical flexion (1,25). A study by Kaale et al. Inferior view of Teleoceras atlas (US Smithsonian National Museum of Natural History, no. Materials and Methods vet-Anatomy is a veterinary atlas of anatomy based on veterinary imaging (MRI, CT, X-Rays) and medical illustrations, designed and created by professional anatomists and veterinary imaging specialists. Due to the capacious nature of the spinal canal at this level these injuries usually present with neck pain without neurological deficits. Figure 1. Both the atlas and axis are small, flat vertebrae. Because spondyloarthropathy has been documented in 23% of Teleoceras 7, 8, its pathology may be related to inflammation. It is concave in front, convex behind and broader at the middle than at the ends. . the beloved residents of the Dept. The ligamentous junction of the occiput and superior cervical spine includes the synovial articular capsules, anterior atlantooccipital membrane, apical ligament of the dens, superior crus of the transverse ligament, paired alar ligaments, transverse ligament, tectorial membrane, and posterior atlantooccipial membrane. Dens was capped by alar ligament calcification and crowned dens. The transverse ligament of the atlas (TLA) is a thick, strong band of approximately 20mm in length [1] which arches across the ring of the atlas and maintains the odontoid process in contact with the anterior arch. the pelvic floor, (Syn: Cardinal ligament, transverse cervical) and the pelvic viscera. Transverse arytenoid ligament - Ligamentum arytenoideum [arytaenoideum] transversum . The transverse ligament runs posterior to the dens (and anterior to the spinal cord), forming the posterior wall of the joint On the posterior aspect of the dens are two facets for attachment of the alar ligaments. It also seeks to assess the main computed tomography appearances of these calcifications. References Promoted articles ADVERTISEMENT: Supporters see fewer/no ads Computed tomography (CT) scan demonstrated severe canal stenosis, hypoplastic posterior arch of atlas vertebra, and ossification of the transverse atlantal ligament (Figure 2). The predictive value and positive likelihood ratios of the transverse ligament test were found to be . The transverse ligament of is a thick, strong band which arches across the ring of the atlas and retains the odontoid process in contact with the anterior arch. A, Thickness of transverse ligament was measured on midsagittal T1 volumetric interpolated breath-hold examination (VIBE) image from posterior border of dental cortical bone to tectorial membrane parallel to reference line from most anterior point of anterior atlantic arch to most anterior point of posterior atlantic arch (volume increase). Forward movement of the atlas on the axis is normally restricted by the transverse ligament The transverse ligament is the primary restraint against atlantoaxial, anteroposterior movement Atlantoaxial instability is defined by an increase in the predentate space of greater than 3 mm in adults and 5 mm in children It is also known that collision related forces can damage soft tissues and joint structures resulting in altered biomechanical conditions for active and normal neck motion. Asymmetry of the dento-axial joint space between left and right (white arrows) with widening on the left side. Level C1: Atlas. The transverse ligament is a variable band-like intracapsular knee ligament. The treatment of atlantoaxial instability has previously been based on criteria drawn from computerized tomography or plain radiographic studies, which only indirectly assess the probability of rupture of the transverse ligament. Radiology Reference Article, whereas vertebrae with atypical features are given unique . Various clini- cal tests have been used to evaluate transverse ligament integrity. There was no evidence of a transverse ligament injury. Immediately behind the transverse ligament and odontoid process is a canal that extends the entire length of the spine. The bundles of collagenous fibers that form ligaments tend to be pliable but not elastic. The tear of this ligament induces a significant alteration of the kinematics and load distribution within the C0-C2 complex, making virtually any head motion potentially fatal. Transverse Ligament Rupture. The transverse ligament of atlas is arguably the most important ligament in the body 1. Le ligament transverse stabilizes the position of the head on the spine and prevents excessive movement that could damage delicate . La spine consists of the juxtaposition of bones called vertebrae. The transverse or [anterior] meniscomeniscal ligament is a ligament in the knee joint that connects the anterior convex margin of the lateral meniscus to the anterior end of the medial meniscus . Thickness of the transverse ligamentThe thick-ness of the transverse ligament was measured in the midsagittal T1 VIBE sequence from the Objective: This study seek to establish the prevalence of calcification of the transverse ligament of the atlas (TLA) and of crowned dens syndrome (CDS) in patients with articular chondrocalcinosis. 93989). of Obst & Gyne and the faculties of the Dept of Radiology, AGMC, Agartala, . Dynamic lateral plain radiographs showed irreducible atlantoaxial subluxation (AAS). If the head is turned during a rear-end collision, this ligament can be stretched or torn, resulting in chronic pain and loss of neck function. A computed tomogram revealed ossified mass compatible to ossification . It is divided into several strips in ten percent of subjects [1] and its thickness varies considerably in different subjects. Source. Patients andmethods PATIENTS Westudied 21 patients (18 women . 1. Taken together, the findings were suggestive of an isolated rupture of the left alar ligament. The imaging findings of important craniocervical junction injuries, such as atlanto-occipital dissociation, occipital condyle fractures, atlas fractures with transverse ligament rupture, atlantoaxial distraction, and traumatic rotatory subluxation, are important to recognize in the acute setting, often dictating patient management. ligament. transverse band (also known as the transverse atlantic or atlantal ligament ): attaches to a small tubercle on the medial cortex of the C1 (atlas) lateral masses on both sides anterior to the tectorial membrane and dura. The transverse ligament arises from the tubercle on the atlas (C1) and holds the chondral surface of the odontoid process firmly against the anterior arch. These ligaments connect the dens to the medial aspect of each occipital condyle and help restrict excessive rotation of the head. Le ligament transverse de l ' atlas is a ligament essential to support the weight of the head on the spine. the transverse ligament ofthe atlas (TLA), as revealed by computed tomography." The presentstudysoughtto establishanassociation between articular chondrocalcinosis and calcification of the TLA, and to assess the frequency and main computed tomography appearancesofthese calcifications. The transverse ligament of the knee, also called the transverse intermeniscal ligament attaches transversely across the anterior aspects of the convex margins of the medial and lateral menisci.

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