The cervical supraspinous ligament connects the spinous process tips from C7 caudally, merging with the nuchal ligament superiorly. It is weaker in the cervical spine than the thoracic and lumbar levels. Its disruption in hyperflexion injuries is the surface sign of posterior column failure. Combined with the nuchal ligament it provides the posterior passive restraint to excessive cervical flexion.
| Origin | External occipital protuberance (merging with the nuchal ligament superiorly) |
|---|---|
| Insertion | Spinous process tips of C7 downward (becoming the thoracic supraspinous ligament) |
| Actions | Resists cervical flexion; the superficial component of the posterior tension band |
|---|
Supraspinous ligament tenderness along the spinous processes is elicited in cervical sprain and flexion-distraction injuries. Its disruption without bony injury (ligamentous instability) requires dynamic flexion-extension radiographs to demonstrate abnormal intervertebral motion.
Hyperflexion disruption producing posterior midline cervical tenderness managed with collar and physiotherapy.
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