Arnold’s ligament and its contribution to the neck–tongue syndrome (NTS)

  • G. A. Tsakotos
  • S. I. Anagnostopoulou
  • D. S. Evangelopoulos
  • M. Vasilopoulou
  • P. I. Kontovazenitis
  • S. D. Korres
Original Article


The neck–tongue syndrome (NTS) is a disorder, due to the compression of the second cervical root nerve. The compression occurs either at the atlanto-axial space or at the exit of the hypoglossal nerve. Many factors can be held responsible for the development of the lesion, including atlanto-axial dislocation, rheumatoid arthritis and irritation from the nearby tectorial membrane and/or capsule of the atlanto-axial joint. A cadaveric specimen study was undertaken in order to identify the ligament of Arnold, one of the predisposing factors involved in the development of this syndrome. Eight cadaveric specimens were dissected and the ligament of Arnold (accessory atlantoaxial ligament) was identified. A full investigation was performed. In half of the cases, the ligament was extending upwards to the occipitum We observed that Arnold’s ligament was found to be contracted during rotational movements of the head, while in flexion-extension, it was rather relaxed. During the rotation of the head it could, under certain circumstances, irritate the second cervical nerve root as well as the hypoglossal nerve at its exit from the foramina magna.


Arnold’s ligament Accessory atlantoaxial ligament NTS 

Le ligament d’Arnold et sa contribution au syndrome hypoglosso-cervical


Le syndrome Cervico-hypoglosse (NTS pour Neck-Tongue Syndrome) est dû à une compression de la deuxième racine nerveuse cervicale. La compression se produit soit dans l’espace atlas-axis, soit à l’émergence du nerf hypoglosse. Beaucoup de facteurs peuvent être avancés pour expliquer cette lésion, incluant la luxation atlas-axis, arthrose rhumatoïde, l’irritation du nerf par la membrane tectoriale et/ou la capsule de l’articulation axo-atloïdienne. Une étude cadavérique a été entreprise pour identifier le ligament d’Arnold, l’un des facteurs prédisposants dans l’installation de ce syndrome. Huit cadavres ont été disséqués et le ligament d’Arnold (ligament atlanto-axial accessoire) a été mis en évidence. Une investigation complète a ensuite été réalisée. Dans la moitié des cas, le ligament se poursuivait vers le haut, vers l’occiput. Nous constatâmes que le ligament se tendait lors des mouvements de rotation et était plutôt relâché en flexion-extension. Lors de la rotation dela tête, il peut dans certaines circonstances, irriter le deuxième nerf cervical ainsi que le nerf hypoglosse dans son émergence du foramen magnum.

Mots clés

Ligament d’Arnold Ligament atlanto-axial accessoire Syndrome cervico-hypoglosse 


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Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • G. A. Tsakotos
    • 1
  • S. I. Anagnostopoulou
    • 2
    • 3
  • D. S. Evangelopoulos
    • 1
  • M. Vasilopoulou
    • 2
  • P. I. Kontovazenitis
    • 1
  • S. D. Korres
    • 1
  1. 1.Orthopaedic Clinic, Medical SchoolUniversity of Athens, KAT HospitalAthensGreece
  2. 2.Department of Anatomy, Medical SchoolUniversity of AthensGoudi, AthensGreece
  3. 3.Athens, HellasGreece

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