Anatomy of Alar Ligament Part III: Biomechanical Study.

Document Type


Publication Date


Publication Title

World Neurosurg


Aged; Aged, 80 and over; Atlanto-Axial Joint; Atlanto-Occipital Joint; Biomechanical Phenomena; Cadaver; Female; Humans; Ligaments, Articular; Male


OBJECTIVE: Four layers of ligamentous stabilizers comprise the craniocervical junction, and the second layer is composed of apical and paired alar ligaments. The purpose of this study is to establish the tensile strength of the alar ligaments for better understanding the implications that can arise from trauma and other pathologies in the craniocervical region.

METHODS: Nineteen sides from 10 fresh frozen adult cadaveric Caucasian heads were used in this study. The specimens were derived from 6 males and 4 females, and the age of the cadavers at death ranged from 67-90 years old. To measure the tensile strength, a tensile testing machine (M2-200, Mark-10 Corporation, Copiague, New York, USA) was used in this study.

RESULTS: The force (N) necessary until failure for all alar ligaments ranged from 87-346 N with a mean of 186.9 ± 69.7 N. There was a significant difference when comparing tensile strength between males and females.

CONCLUSIONS: Further studies will be necessary to determine their importance as secondary stabilizers and measure their ability to support similar forces when subject to rotation and lateral bending forces, as well as with flexion-extension.

Clinical Institute

Neurosciences (Brain & Spine)