Pediatric Neurosurgery, Children's Hospital, Birmingham, Alabama, USA.
World Neurosurg. 2012 May-Jun;77(5-6):775-7. doi: 10.1016/j.wneu.2011.09.048. Epub 2011 Nov 1.
Knowledge of the anatomy of the ligaments that unite the head to the neck is important to the clinician who treats patients with lesions in this region. Although the anatomy and function of the majority of these ligaments have been well described, some are relatively unknown. One of these includes the anterior atlantodental ligament (AADL). Our goal was to increase knowledge about the AADL.
We dissected the craniocervical junction in sixteen adult cadavers and paid special attention to the presence and anatomy of the AADL.
The AADL was found in 81.3% of specimens. The attachment of each ligament was consistent and traveled between the base of the anterior dens to the posterior aspect of the anterior arch of the atlas in the midline and just inferior to the fovea dentis. In 38.5% of specimens, there was some connection between the AADL and the anterior atlanto-occipital membrane. The ligament was roughly 4 × 4 × 4 mm in all specimens. With transection of the transverse ligament, the AADL could be made taut with posterior distraction of the dens. In addition, with left and right rotation of the atlantoaxial joint, the AADL became taut (less than 10°) before any tautness of the alar ligaments in all specimens.
The AADL appears to resist posterior displacement of the dens and, with the alar ligaments, resists rotation. When present, the AADL contributes to the predental space. Knowledge of this ligament may aid in further understanding craniocervical stability and help in differentiating normal anatomy from pathology via 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。尽管大多数这些韧带的解剖结构和功能已经得到很好的描述，但有些韧带相对未知。其中之一包括前寰齿韧带（AADL）。我们的目标是增加对 AADL 的了解。
我们在 16 具成人尸体上解剖了颅颈连接，并特别注意 AADL 的存在和解剖结构。
AADL 在 81.3%的标本中存在。每条韧带的附着点都一致，从中线的前齿突基底到寰椎前弓后表面，并位于齿突凹下方。在 38.5%的标本中，AADL 与前寰枕膜之间存在一定的联系。韧带在所有标本中大小约为 4×4×4mm。横韧带切断后，可通过 dens 的后向牵引使 AADL 拉紧。此外，在寰枢关节左右旋转时，AADL 在所有标本的翼状韧带紧张之前（小于 10°）变得紧张。
AADL 似乎可抵抗 dens 的后向移位，并与翼状韧带一起抵抗旋转。当存在时，AADL 有助于齿突前间隙。了解该韧带可能有助于进一步了解颅颈稳定性，并通过影像学手段帮助区分正常解剖结构和病理。
