The anterior longitudinal ligament extends from the skull base down the anterior vertebral column, closely adherent to the vertebral body periosteum and disc anulus. In the cervical spine it resists the hyperextension mechanism of whiplash injuries. Disruption indicates severe hyperextension trauma such as a hangman's fracture at C2.
| Origin | Anterior atlas (C1) |
|---|---|
| Insertion | Continuous down the anterior vertebral bodies to the sacrum |
| Actions | Resists cervical hyperextension; limits anterior disc prolapse |
|---|
ALL disruption in cervical whiplash produces ligamentous instability visible on flexion-extension radiographs as excessive anterior vertebral translation. MRI shows T2 signal in the anterior soft tissues. Severe ALL disruption requires surgical stabilisation.
Anterior longitudinal ligament tear from severe cervical hyperextension producing instability managed with collar immobilisation or surgical fusion.
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