The tectorial membrane is the upward continuation of the posterior longitudinal ligament from C2 to the anterior margin of the foramen magnum and the basion. It lies posterior to the dens and cruciform ligament, forming the posterior boundary of the craniovertebral junction.
Acts as the secondary posterior restraint at the craniovertebral junction, limiting excessive extension and forward translation of the skull on C1-C2. Provides the posterior longitudinal ligament continuum from the cervical spine to the skull base.
Tectorial membrane disruption occurs with high-energy occipital condyle fractures and atlantoaxial fracture-dislocations. Its integrity on MRI assessment is used in determining the stability of craniovertebral junction injuries. Division of the tectorial membrane is required in some posterior approaches to the craniocervical junction.
Tectorial membrane disruption accompanying high-energy craniocervical junction injuries, indicating instability requiring surgical stabilisation.
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