The anterior atlanto-occipital membrane connects the anterior arch of the atlas to the anterior margin of the foramen magnum and the basilar part of the occiput, continuing as the anterior longitudinal ligament at this level.
Restrains excessive extension of the head on the atlas (C0-C1 joint), limits anterior translation, and provides the anterior fibrous floor of the craniovertebral junction.
This membrane is assessed in craniocervical junction injuries — its disruption is part of the spectrum of craniocervical dissociation (the most lethal cervical spine injury). Division of this membrane provides anterior access to the C1-C2 articulation in transoral or endoscopic approaches.
Anterior atlanto-occipital membrane rupture as part of complete craniocervical ligamentous disruption producing life-threatening instability at the skull-spine junction.
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