The apical ligament: anatomy and functional significance

Object. The authors conducted a study to describe the detailed anatomy of t he apical ligament and to acknowledge or refute its historical description as a functionally significant contributor to craniocervical stability. Methods. In 20 adult human cadavers measurements of the apical ligament wer e obtained, and its detailed anatomy was observed. Ranges of motion were al so assessed to discern the function of the apical ligament. Conclusions. Results of the study support the concept that the apical ligam ent is best described as a vestigial structure that offers no significant a dded stability to the craniocervical junction. In fact, this ligament was a bsent in 20% of the specimens examined. These data will aid physicians who frequently view images or manage clinical problems of the craniocervical ju nction because they may focus on other ligaments of this area and not the a pical ligament.