Cruciate ligament of the atlas

Last revised by Henry Knipe on 9 Aug 2023

The cruciate ligament of the atlas (also known as the cruciform ligament) is an important ligamentous complex that holds the posterior dens of C2 in articulation at the median atlantoaxial joint. It lies behind a large synovial bursa (surrounded by loose fibrous capsule) and consists of two bands:

  • longitudinal band

  • transverse band (also known as the transverse atlantic or atlantal ligament)

    • attaches to a small tubercle on the medial cortex of the C1 (atlas) lateral masses on both sides anterior to the tectorial membrane and dura

    • passes posterior to the dens, with a small intervening synovial capsule, fixing the dens to the posterior margin of the anterior arch of the atlas

    • strongest spinal ligament 2

With the alar ligament, the transverse band is the primary stabilizer of the atlantoaxial joint 2.

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Cases and figures

  • Figure 1
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  • Figure 2: median atlanto-occipital and atlantoaxial joints (Gray's illustration)
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  • Figure 3: C0-1-2 ligaments (Gray's illustration)
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  • Figure 4: atlanto-odontoid joint (Gray's illustration)
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  • Figure 5: annotated image
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  • Case 1: calcification of the transverse band
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