Skip to main content
SpringerLink
Log in

“V” shaped predens space

  • Articles
  • Published:
Skeletal Radiology Aims and scope Submit manuscript

Abstract

“V” shaped widening of the predens space (PDS) in flexion can be a worrisome finding in trauma patients, possibly representing injury to the transverse ligament. These patients may also show widening of the C-1/C-2 interspinous distance. We think this appearance is usually due to increased flexion mobility at the atlantoaxial level with developmental elongation or laxity of the cranial end of the transverse ligament and/or the posterior ligamentous complex. Tearing of only the cranial end of the transverse ligament must be extremely rare, if it occurs at all; there is no reported proven case. Tearing of only posterior ligaments seems possible and should be evaluated clinically.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Althoff B, Goldie IF (1981) Causes of atlanto-axial dislocation and the strength of posterior fixation. Arch Orthop Trauma Surg 98:79

    Google Scholar 

  2. Coults MB (1934) Atlanto-epistropheal subluxations. Arch Surg 29:297

    Google Scholar 

  3. Daniels DL, Williams AL, Haughton VM (1983) Computed tomography of the articulations and ligaments of the occipito-atlantoaxial region. Radiology 146:709

    Google Scholar 

  4. Englander O (1942) Non-traumatic occipito-atlanto-axial dislocation. A contribution to the radiology of the atlas. Br J Radiol 15:341

    Google Scholar 

  5. Fielding JW, Van Cochran GB, Lawsing JF III, Hohl M (1974) Tears of the transverse ligament of the atlas. J Bone Joint Surg [Am] 56:1683

    Google Scholar 

  6. Gehweiler JA Jr, Duff DE, Martinez S, Miller MD, Clark WM (1976) Fractures of the atlas vertebra. Skeletal Radiol 1:97

    Google Scholar 

  7. Greenberg AD (1968) Atlanto-axial dislocations. Brain 91:655

    Google Scholar 

  8. Hanafee W, Crandall P (1966) Trauma of the spine and its contents. Radiol Clin North Am 4:365

    Google Scholar 

  9. Jackson H (1983) Atlantoaxial subluxation. Radiology (letter to the editor) 148:864

    Google Scholar 

  10. Krantz P (1980–81) Isolated disruption of the transverse ligament of the atlas: an injury easily overlooked at postmortem examination. Injury 12:168

    Google Scholar 

  11. Pennecot GF, Gouraud D, Hardy JR, Pouliquen JC (1984) Roentgenographical study of the stability of the cervical spine in children. J Pediatr Orthop 4:346

    Google Scholar 

  12. Penning L (1978) Normal movements of the cervical spine. AJR 130:317

    Google Scholar 

  13. Shapiro R, Youngberg AS, Rothman SLG (1973) The differential diagnosis of traumatic lesions of the occipital-atlanto-axial segment. Radiol Clin North Am 11: 505

    Google Scholar 

  14. Spence KF Jr, Decker S, Sell KW (1970) Bursting atlantal fracture associated with rupture of the transverse ligament. J Bone Joint Surg [Am] 52:543

    Google Scholar 

  15. Swischuk LE, Hayden CK Jr, Sarwar M (1979) The posteriorly tilted dens. A normal variation mimicking a fractured dens. Pediatr Radiol 8:27

    Google Scholar 

  16. Wackenheim A (1974) Roentgen diagnosis of the craniovertebral region. Springer, New York, p 267

    Google Scholar 

  17. Werne S (1957) Studies in spontaneous atlas dislocation. Acta Orthop Scand Suppl 23

  18. Wollin DG, Botterell EH (1958) Symmetrical forward luxation of the atlas. AJR 79:575

    Google Scholar 

Download references

Author information

Author notes

  1. W. Martin III

    Present address: Department of Radiology, High Point Memorial Hospital, 27260, High Point, NC, USA

Authors and Affiliations

  1. Department of Radiology, Bowman Gray School of Medicine, Wake Forest University, Winston-Salem, North Carolina, USA

    S. P. Bohrer M.D., A. Klein M.D. & W. Martin III

Authors
  1. S. P. Bohrer M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A. Klein M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. W. Martin III
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bohrer, S.P., Klein, A. & Martin, W. “V” shaped predens space. Skeletal Radiol 14, 111–116 (1985). https://doi.org/10.1007/BF00349745

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00349745

Key words

Search

Navigation