The posterior ligamentous complex of the cervical spine — comprising the facet capsules, ligamentum flavum, interspinous, and supraspinous ligaments — acts as the posterior tension band preventing excessive flexion and distraction. Complete PLC disruption indicates a potentially unstable cervical injury requiring surgical stabilisation. MRI is the gold standard for PLC assessment after cervical fracture.
| Origin | Posterior cervical laminae, spinous processes, and facet capsules |
|---|---|
| Insertion | Continuous from occiput to thoracic junction — includes interspinous, supraspinous, facet capsules, and ligamentum flavum |
| Actions | Tension band system resisting cervical flexion and distraction; primary posterior column stability |
|---|
The Subaxial Cervical Spine Injury Classification (SLIC) assigns 2 points to distraction injuries and 2 points to PLC disruption — combined with disc morphology scores, total score above 4 warrants surgical treatment. Facet joint capsule disruption is the most sensitive indicator of PLC failure.
Posterior ligamentous complex tearing in cervical flexion-distraction injury indicating instability managed with posterior cervical fusion.
