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Anterior & posterior longitudinal ligament

Two major ligaments run the entire length of the vertebral column: the anterior longitudinal ligament and the posterior longitudinal ligament. Both are essential for maintaining spinal integrity and stability, particularly in case of injury1,2. The anterior longitudinal ligament covers the anterior surfaces of the vertebral bodies and intervertebral discs, while the posterior longitudinal ligament covers the posterior surfaces of these same structures.

  • 1 Stemper BD, Yoganandan N, Pintar FA, Rao RD. Anterior longitudinal ligament injuries in whiplash may lead to cervical instability. Med Eng Phys. 2006 Jul;28(6):515-24.
  • 2 Tominaga Y, Ndu AB, Coe MP, Valenson AJ, Ivancic PC, Ito S, Rubin W, Panjabi MM. Neck ligament strength is decreased following whiplash trauma. BMC Musculoskelet Disord. 2006 Dec 21;7:103.
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    Anterior and anterolateral aspect of the anterior longitudinal ligament
    Anterior and anterolateral aspect of the anterior longitudinal ligament
    The fibers of the anterior longitudinal ligament connect the ventral surfaces of all vertebrae, extending from the anterior tubercle of the atlas (C1) down to the sacrum. Its fibers are relatively thin and delicate in the cervical region, become more consistent in the thoracic segment, and form a strong, broad tendinous meshwork from the lower thoracic level down to the sacrum. In the lumbar region, the ligament broadens to cover the anterolateral surfaces of the vertebral bodies, where its fibers blend with the tendinous crura of the diaphragm*.
  • * Bogduk, Nikolai, and Lance T Twomey. Clinical Anatomy of the Lumbar Spine. 2nd ed. Melbourne ; New York: Churchill Livingstone, 1991. Print. pp.41.
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    Detailed view of the anterior longitudinal ligament Detailed view of the vertebral column with intervertebral discs
    Detailed view of the anterior longitudinal ligament
    A closer examination reveals that the ligament consists of both short fibers, which connect adjacent vertebrae, and long fibers, which span multiple vertebrae. It attaches primarily to the vertebral bodies rather than to the intervertebral discs1,2.
  • 1 Bogduk, Nikolai, and Lance T Twomey. Clinical Anatomy of the Lumbar Spine. 2nd ed. Melbourne ; New York: Churchill Livingstone, 1991. Print. pp.40–41.
  • 2 Sinnatamby C (2011). Last's Anatomy (12th ed.). p. 424.
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    Posterior and posterolateral view of the vertebral column and posterior longitudinal ligament. Vertebral arches removed to reveal the anterior wall of the vertebral canal
    Posterior and posterolateral view of the vertebral column and posterior longitudinal ligament. Vertebral arches removed to reveal the anterior wall of the vertebral canal
    The posterior longitudinal ligament begins on the basilar part of the occipital bone. Its segment at the craniovertebral junction is known as the tectorial membrane. The ligament is broad and relatively thin in the cervical region, becomes narrower and thicker in the thoracic section, and gradually thins out caudally. In the lower lumbar region, it is reduced to a narrow midline band of fibers2. It becomes rudimentary at the sacral level, ending by blending with the periosteum of the sacral canal.
  • 1 Bogduk, Nikolai, and Lance T Twomey. Clinical Anatomy of the Lumbar Spine. 2nd ed. Melbourne ; New York: Churchill Livingstone, 1991. Print. p.40
  • 2 Salaud C, Ploteau S, Hamel O, Armstrong O, Hamel A. Morphometric study of the posterior longitudinal ligament at the lumbar spine. Surg Radiol Anat. 2018 May;40(5):563-569.
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    Posterior longitudinal ligament: comparative anatomy across cervical, thoracic and lumbosacral regions. Vertebral arches removed to expose the ligament on the anterior wall of the vertebral canal Anterior wall of the vertebral canal
    Posterior longitudinal ligament: comparative anatomy across cervical, thoracic and lumbosacral regions. Vertebral arches removed to expose the ligament on the anterior wall of the vertebral canal
    In contrast to the anterior longitudinal ligament, the posterior ligament is more strongly attached to the intervertebral discs than to the vertebral bodies themselves, particularly in the lumbar region*. Click the image to see the large openings on the posterior surface of the vertebral bodies, which serve as entry points for the basivertebral veins.
  • * Bertram C, Prescher A, Fürderer S, Eysel P. Anheftungspunkte des Lig. longitudinale posterius und deren Bedeutung für Wirbelkörperfrakturen [Attachment points of the posterior longitudinal ligament and their importance for thoracic and lumbar spine fractures]. Orthopade. 2003 Oct;32(10):848-51. German.
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    Published: 04.09.2025