The cervical posterior ligamentous complex (PLC) encompasses the supraspinous ligament, interspinous ligaments, ligamentum flavum, and facet joint capsules at each cervical level. Integrity of the PLC determines the stability of cervical flexion-distraction injuries.
Provides the posterior tension band that resists cervical flexion distraction, determines fracture stability classification, and is the structure assessed in the SLIC (Subaxial Cervical Injury Classification) and AO cervical spine classification systems.
PLC disruption produces an unstable cervical injury pattern requiring surgical stabilisation. MRI demonstrates posterior ligamentous complex injury as T2 signal increase posterior to the spinous processes. Intact PLC allows non-operative management of many cervical compression fractures.
MRI-confirmed posterior ligamentous complex disruption converting an apparently stable cervical compression fracture to an unstable pattern requiring posterior cervical fusion.
MRI T2 signal posterior to the spinous processes indicating PLC disruption, the key determinant of surgical versus non-operative management in sub-axial cervical spine injuries.
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