• Burak Karaaslan, Alp Özgün Börcek, Murat Uçar, and Şükrü Aykol.
• Department of Neurosurgery, Çubuk Halil Şıvgın State Hospital, Ankara, Turkey. Electronic address: burakkaraaslan08@hotmail.com.
• World Neurosurg. 2019 Aug 1; 128: e1096-e1101.

ObjectiveThe craniocervical junction permits a certain amount of mobility for the cervical spine. The biomechanical properties of occipital bone-atlas joint mainly depend on the bony structure, and atlas-axis joint biomechanical properties mainly depend on ligamentous structure. The underlying etiologic factor of Chiari malformation (CM) is debatable. Nowadays, some researchers argue that stabilization difference is one of the suspicious factors for etiopathogenesis. We aim to analyze the ligamentous morphometric differences of CM.MethodsMagnetic resonance images of 93 adult healthy subjects (n = 93) without any craniocervical junction development abnormalities and 25 (n = 25) adult patients with craniocervical junction development abnormalities (Arnold CM) were evaluated. Length, width, and length-width ratios of ligaments were evaluated.ResultsLength of transverse ligament (mean: 23 ± 3.6 [range: 12.1-31.4]) in the normal population was significantly longer than transverse ligament length in CM patients (mean: 21.3 ± 2.5 [range: 17.2-24.9]). Length of alar ligament (mean: 10.7 ± 2 [range: 5.1-15.4]) in the normal population was significantly longer than alar ligament length in CM patients (mean: 8.8 ± 3.8 [range: 1.1-16.6]) (P = 0.007).ConclusionsCraniocervical ligaments play an important role in maintaining stability and motion capacity of this region. This study promoted better understanding of craniocervical junction anomalies and provided data that facilitate performing more precise surgical treatment.Copyright © 2019 Elsevier Inc. All rights reserved.

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