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Evaluation of the Spine in a Child
Published in Nirmal Raj Gopinathan, Clinical Orthopedic Examination of a Child, 2021
Ashish Dagar, Sarvdeep Singh Dhatt, Deepak Neradi, Vijay G Goni
Whiplash injury can present with tenderness at the insertion of ligaments. The superior nuchal ligament is a continuation of the supraspinatus ligament in the cervical spine extending from T1 to the occiput in the midline. Tenderness of the nuchal ligament is seen in whiplash injury.
Surgery of the Cervical Spine
Published in Timothy W R Briggs, Jonathan Miles, William Aston, Heledd Havard, Daud TS Chou, Operative Orthopaedics, 2020
The fascia is incised at the midline. Retractors and palpation are used to keep dissection in the midline. The nuchal ligament is split in the midline, and the spinous process is reached. The spinous processes of C3, C4, C5 and C6 are normally bifid.
A to Z Entries
Published in Clare E. Milner, Functional Anatomy for Sport and Exercise, 2019
The neck is the most proximal part of the vertebral column, the cervical region. Therefore, it has several ligaments in common with the thoracic and lumbar regions of the spine. These common ligaments are: the anterior and posterior longitudinal ligaments, ligamentum flavum, interspinous and supraspinous ligaments (see thoracic region – ligaments). There is an additional ligament unique to the cervical region: the nuchal ligament. This ligament runs medially on the posterior aspect of the neck. Specifically, it runs from the external occipital protuberance and posterior border of the foramen magnum of the skull to the spinous processes of the cervical vertebrae. The spinous processes are short in the cervical region of the vertebral column, so the strong and thick nuchal ligament provides a substitute for muscular attachment in this region.
Integrity of the tectorial membrane is a favorable prognostic factor in atlanto-occipital dislocation
Published in British Journal of Neurosurgery, 2020
Gil Kimchi, Gahl Greenberg, Vincent C. Traynelis, Christopher D. Witiw, Nachshon Knoller, Ran Harel
A 12-year-old male fell into an open elevator shaft of two stories height and was bluntly injured in the chest, abdomen and neck. The patient was immobilized in a rigid cervical collar by the medical first responders and was transported to the emergency room. His neurological examination revealed normal motor function (ASIA E) and intact consciousness (GCS15). A CT scan of the head, neck, chest and abdomen was performed. The patient was operated urgently due to a rapidly progressive hemodynamic shock, and splenectomy was performed. Despite a normal Powers ratio (0.8) and a BDI of 11.9 mm, a bilateral subluxation of the atlanto-condylar joints with intra-articular distances of 5.7 and 3.5 mm was demonstrated (Figure 3(A)), leading to the diagnosis of AOD. MRI of the cervical spine performed several hours after surgery revealed a high T2-weighted signal at the alar and apical ligaments as well as ‘stripping’ of the retroclival ligament and an edematous nuchal ligament. There was an effusion in the right atlanto-condylar joint (Figure 3(C)). The patient underwent on the following day an occipitocervical fusion. At his latest follow up visit 4.5 months after surgery (Figure 3(D)), he described normal function in all limbs and had a normal neurological examination.
Comparison of the electromyographic recruitment of the posterior oblique sling muscles during prone hip extension among three different shoulder positions
Published in Physiotherapy Theory and Practice, 2021
The superficial back line consists of the nuchal ligament, trapezius, LD, MF, thoracolumbar fascia, hamstrings, gastrocnemius, and plantar fascia (Myers, 2013). The trapezius muscle group, particularly the middle (midT) and lower (lowT) trapezius, is aligned with elements of the posterior oblique sling in the superficial back line (Myers, 2013). MidT and lowT alignment with the thoracic region depends on muscle slings in the trunk, which are important for controlling trunk and pelvic rotation such as straight leg raising and PHE (Kim, Kang, and Oh, 2014; Myers, 2013).
Contribution of injured posterior ligamentous complex and intervertebral disc on post-traumatic instability at the cervical spine
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2020
Marie-Hélène Beauséjour, Yvan Petit, Jeremy Hagen, Pierre-Jean Arnoux, Jean-Marc Mac Thiong, Eric Wagnac
The posterior ligamentous complex (PLC), which comprises the ligamentum flavum (LF), interspinous ligament (ISL) and nuchal ligament (NL) (Rasoulinejad et al. 2012) and the intervertebral disc (IVD) (Nadeau et al. 2012) play a critical role in cervical spine stability. Flexion-distraction injuries characterized by PLC and IVD disruption are frequent at the cervical spine and result in serious neurological consequences (Blauth et al. 2007).