Biomechanics of the Spine III. The Cranio-Cervical Junction

By virtue of its unique anatomy and functions the cranial-cervical junction was excluded in previous reviews on the general biomechanics of the spine, being a world apart. The special design of the cranial-cervical (CCJ) junction responds to seemingly opposed necessities being at same time loose enough to allow a great variety of movements and strong enough to preserve the spinal cord and vertebral arteries and to resist the head weight and muscular action. The primary goal of the CCJ is to ensure the maximal mobility of the head for visual and auditory exploration of space. Like a cardan joint the CCJ allows simultaneous independent movements about three axes in order to repeat and extend eye movements under the control of vestibular receptors. Several muscular groups and a number of ligaments control the movements of the CCJ and ensure its stability. Although composed of two seemingly distinct joints the CCJ forms a unique functional complex whose stability is ensured by ligaments and bony restraints often operating on both joint components: the occipitoatlantal and atlantoaxial joints.