Ligamentum Nuchae Detail

ligamentum nuchae detail

The ligamentum nuchae is a large median fibroelastic intermuscular septum of the posterior neck, extending from the external occipital protuberance to the spinous process of C7, homologous to the supraspinous ligament of the thoracic and lumbar spine.

Region: Neck

Biomechanics

Function & Actions

Provides passive support to the head in the upright position by resisting cervical flexion, serves as the median intermuscular septum separating left and right posterior cervical muscles, and provides the midline attachment for the posterior cervical musculature.

Clinical Relevance

Clinical Notes

The ligamentum nuchae is the landmark for the posterior midline cervical approach — incision directly through the ligament splits between left and right muscle groups, providing a relatively avascular dissection plane. Nuchal ligament calcification (calcific tendinitis) produces acute posterior neck pain mimicking meningismus.

Pathology

Common Injuries & Conditions

Nuchal Ligament Calcific Tendinitis

Calcium hydroxyapatite deposition in the ligamentum nuchae producing acute posterior neck pain, stiffness, and occasionally fever mimicking meningitis, resolving with anti-inflammatory treatment.

Midline Cervical Approach Through Ligamentum Nuchae

Posterior cervical laminectomy and fusion via the midline nuchal ligament incision, splitting between left and right paraspinal muscles for bilateral decompression.