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Anderson and Montesano12 Classification of Occipital Condyle Fractures Type Description Biomechanics Type I Impaction Results from axial loading; ipsilateral alar ligament may be compromised, but stability is maintained by contralateral alar ligament and tectorial membrane Type II Skull base extension Extends from occipital bone via condyle to enter foramen magnum; stability is maintained by intact alar ligaments and tectorial membrane Type III Avulsion Mediated via alar ligament tension; associated disruption of tectorial membrane and contralateral alar ligament may cause instability Table 2.
Ligaments stabilizing the atlantoaxial junction (C1-C2 joint), which are shown in Figure 1, include the tectorial membrane, the cranial extension of the posterior longitudinal ligament that limits axial distraction; the alar ligaments, which transfix the dens to the occipital condyles to restrain rotational motion; and the transverse atlantal ligament (TAL), which restricts the dens from impacting the cord in flexion.
Magnetic resonance imaging can be employed to evaluate the transverse ligament, alar ligaments, and spinal cord [4, 24].
The magnetic resonance imaging (MRI) findings suggest that the alar ligament injury is the most important cause for atlantoaxial subluxation (11,14).
Analysis of MRI and MRI video findings in craniocervical instability pathology of 420 patients with clinical symptoms consistent with possible spinal instability Findings Patients n (%) Complete alar ligament rupture [*] 20 (4.