The term wing ligament belongs to a group of wing ligaments consisting of two ligaments that are used in the area of the upper cervical joints. In short, these wing ligaments always hold the head in position, even when it is moved. Each wing ligament has its own tasks. Injury to one or both wing ligaments can result in various unpleasant displacements or even dislocations of the head from the cervical spine. Such injuries are usually so-called bony ligament tears, which can be caused by particularly violent movements, for example in an accident. In order to accurately diagnose such injuries, it is first necessary to perform a computer tomography and then to confirm this diagnosis by MRI, which is successful in most cases. After that, treatment can then be targeted.
What is the wing ligament?
A wing ligament is a band of very tough, short, fibrous fibers. There is not just one wing ligament in the human body, but two wing ligaments. Wing ligaments are found only in the upper cervical region. The scientific name for wing ligament is ligamentum alare. In English, the term check ligament of the odontoid is used for a single wing ligament. Mostly, however, we speak of the plural, i.e. the wing ligaments. Among other things, these are otherwise called alar ligaments, alarligaments, or ligamenta alaria.
Anatomy and structure
The wing ligaments are located at the occipital bone. This is the junction of the cervical junction on the cranium. It is the termination of the cranial cavity at the back, where the atlas is the first cephalic joint. The tough fibers of the wing ligaments are located midway between the massa lateralis of the atlas. There are two wing ligaments, one left and one right. They enclose the odontoid process. The two wing ligaments form an angle of approximately 170 degrees.
Function and tasks
The function of the ligamenta alaria, or wing ligaments, is to provide stability to the skull relative to the cervical spine while still allowing for necessary movement. They have, so to speak, a braking and holding function in this area. Even if the head rotates, the function of these wing ligaments prevents lateral displacement, which is very important, especially in the area of the head. Another function of the wing ligaments is to prevent displacement even during flexion or other axis rotation of the skull. The wing ligaments keep both the second cervical vertebra and the first cervical vertebra, which is after all connected to the second cervical vertebra, centered at all times, no matter where the base of the skull is currently located as a result of any movement. It is important to note that even if the head is tilted sideways, the so-called laterial flexion, nothing happens through these wing ligaments. The head thus always remains connected to the cervical vertebrae so that it cannot slip. A so-called translation or even subluxation, whereby it can come to the dislocation of a joint, cannot happen so easily by the wing ligaments between head and spinal column, if these ligaments function properly and are not injured. Also, any other conceivable rotation of the head is normally always compensated for by these particularly tough, stable ligaments. Only unusually violent rotations or else laterals are able to cause injury to the wing ligaments.
Diseases
Based on the above description of what tasks the ligamenta alaria, or in German wing ligaments, have, it is not difficult to imagine what can happen when one wing ligament, or even all of them, can no longer fulfill their stabilizing function. The head must be mobile in relation to the joints that connect it to the spine, but precisely because of its weight it must not slip or even be displaced in relation to the cervical spine due to a dislocation. However, such a thing can happen, namely in the case of injuries to the cervical spine. Such injuries can occur when there is a particularly jerky, strong lateral flexion of the head or a particularly violent rotation of the head. This can result in bony ligament tears of the ligamenta alaria or also of a ligamentum alare, i.e. wing ligament. This then results in a displacement of the head relative to the vertebrae of the cervical spine.Depending on whether only one wing ligament or both wing ligaments are affected by such bony ligament tears, this displacement of the head is either unilateral or even bilateral. A typical injury of this type is the fracture of the occipital condyles type III according to Anderson and Montesanto. However, there are other injuries to the wing ligaments or one of the wing ligaments that are possible. These include atlanto-occipital dissociation or else atlanto-axial rotational instability, which is also often found under the abbreviation AARI. If there is a suspicion that such an injury to the wing ligaments or a single wing ligament may have occurred, then it is important to obtain clarification. Computer tomography is particularly suitable for an exact diagnosis. After that, it is important to confirm the diagnosis, which is usually done well with MRI. The treatment required thereafter is then based on the specific diagnosis.
