Anatomy and Biomechanics of the Craniocervical Junction

It is important for surgeons to understand the anatomical and functional relationships of the bony articulations and ligaments of the craniocervical junction to allow them to predict the effect of injuries and surgical fixation on the stability of this region. The functional anatomy of the cranio-vertebral junction is described, with focus on its complex ligamentous structure. The functional consequences of several types of injuries are examined, including hyperrotation, compression, hyperflexion, hyperextension, and iatrogenic injuries. Anatomical and biomechanical limitations of fixation devices that use screws or cables for immobilizing C0-1, C1-2, or C0 through C2 are summarized. KEYWORDS Ligament - injury - biomechanics - functional anatomy - cervical spine