Anterior Longitudinal Ligament (Cervical) Detail

ligamentum longitudinale anterius cervicale detail

The cervical anterior longitudinal ligament runs along the anterior vertebral bodies from C2 to the thoracic spine, firmly adhering to the endplates but loosely attached over the disc annuli. It is broader and thicker than the PLL at this level.

Region: Neck

Biomechanics

Function & Actions

Resists cervical hyperextension, reinforces the anterior disc annulus, maintains anterior column vertebral alignment, and is the primary restraint against extension-type cervical injuries.

Clinical Relevance

Clinical Notes

The cervical ALL is disrupted in extension-type cervical spine injuries — the classic extension-distraction injury of the osteoporotic patient produces an ALL tear without fracture, presenting as an acute disc herniation pattern. In anterior cervical approaches, the ALL is preserved as a posterior restraint to prevent over-distraction.

Pathology

Common Injuries & Conditions

Cervical ALL Disruption in Extension Injury

Anterior longitudinal ligament tear from hyperextension in a spondylotic cervical spine producing anterior disc-osteophyte complex displacement and acute central cord syndrome.

Cervical ALL Calcification in Diffuse Hyperostosis

DISH calcification of the cervical ALL producing dysphagia from anterior osteophyte compression of the oesophagus, requiring osteophyte resection when symptomatic.