03/18/2026
The alar ligaments help stabilize the upper cervical spine. They run from the dens of C2 (axis) to the occipital condyles and act as the main restraint to excessive rotation and lateral bending of the head.
One way we can evaluate potential injury to these ligaments is with lateral bending cervical radiographs.
When the alar ligaments are functioning properly, they limit how much the atlas (C1) can shift relative to C2 during side bending.
If there’s an injury or laxity, imaging may show asymmetrical motion or excessive lateral movement of C1 on C2.
Even small changes in stability at the upper cervical spine can contribute to symptoms like neck pain, headaches, dizziness, and persistent post-traumatic complaints.
Understanding the anatomy and knowing what to look for on imaging can make a big difference when evaluating complex cervical spine cases.
