Pediatric Neurosurgery, Children's Hospital, Birmingham, Alabama 35233, USA.
J Neurosurg Spine. 2010 Jun;12(6):619-22. doi: 10.3171/2009.12.SPINE09671.
Knowledge of the anatomy of the ligaments that unite the head with the neck is important to the clinician who treats patients with lesions in this region. Although the anatomy and function of these ligaments have been well described, those of the Barkow ligament (BL) have yet to be studied.
Via an anterior approach, 13 unembalmed adult cadavers underwent dissection of the craniocervical junction with special attention to the presence, anatomy, and function of the BL.
The BL was found in 92.3% of specimens. The attachment of each ligament onto the medial aspect of the occipital condyle was consistent and just anterior to the attachment of the alar ligaments. In 75% of specimens, there was some connection between the BL and the anterior atlantooccipital membrane. Connections between other adjacent ligamentous structures were not identified. The average width, length, and thickness of the BL were 4, 2.5, and 3.5 mm, respectively. With ranges of motion of the craniocervical junction, only extension of the atlantooccipital joint produced tension in the BL. The mean tension to failure of the ligament was 28 N. Statistical analysis revealed no significant difference in width, length, and thickness of the ligaments based on sex.
The BL was found in all but 1 of our specimens. This ligament appears to resist extension of the atlantooccipital joint and may be synergistic with the anterior atlantooccipital membrane. Interestingly, the function of this ligament as found in this study relies on the integrity of the transverse ligament. Knowledge of this ligament may aid in further understanding craniocervical stability and help in differentiating normal from pathological tissue using imaging modalities.
了解连接头部和颈部的韧带解剖结构对于治疗该区域病变患者的临床医生非常重要。尽管这些韧带的解剖结构和功能已经得到了很好的描述，但 Barkow 韧带（BL）的解剖结构尚未得到研究。
通过前路入路，对 13 具未经防腐处理的成人尸体的颅颈交界区进行解剖，特别注意 BL 的存在、解剖结构和功能。
BL 在 92.3%的标本中被发现。每条韧带附着于枕骨髁内侧的附着点是一致的，刚好在前翼韧带附着点的前方。在 75%的标本中，BL 与前寰枕膜之间存在一定的连接。未发现其他相邻韧带结构之间的连接。BL 的平均宽度、长度和厚度分别为 4、2.5 和 3.5mm。在颅颈关节的运动范围内，只有寰枕关节的伸展才会使 BL 产生张力。韧带的平均失效张力为 28N。统计分析显示，BL 的宽度、长度和厚度在性别上无显著差异。
除 1 例标本外，我们所有标本均发现 BL。该韧带似乎可以抵抗寰枕关节的伸展，并且可能与前寰枕膜协同作用。有趣的是，本研究中发现的该韧带的功能依赖于横韧带的完整性。了解该韧带可能有助于进一步了解颅颈稳定性，并有助于通过影像学手段区分正常和病理性组织。
