When testing for cervical instability, one of the commonly used methods is the Transverse Ligament Test. This test specifically assesses the integrity of the upper cervical spine, particularly the transverse ligament and the stability of the atlas (C1) and axis (C2) vertebrae.
To perform the Transverse Ligament Test, the patient is positioned in a supine (lying on their back) position. The examiner then places their fingers on the posterior aspect of the patient’s C1 spinous process and their thumbs on the posterior aspect of the patient’s C2 spinous process.
The examiner’s fingers and thumbs should be overlying the neural arches of the atlas and axis vertebrae. Once in position, the examiner gently lifts the patient’s head and C1 vertebra, taking care not to apply excessive force or cause discomfort.
During this process, the examiner is assessing for any excessive movement or translation between the atlas and axis vertebrae. If there is excessive movement or instability, it may indicate a disruption or laxity of the transverse ligament, which can be a sign of cervical instability.
It is important to note that the Transverse Ligament Test should be performed by a trained healthcare professional, such as a physical therapist or chiropractor, who is knowledgeable and experienced in assessing cervical stability. The test should be performed with caution and care to ensure the safety and comfort of the patient.
In addition to the Transverse Ligament Test, there are other clinical tests and imaging techniques that can be utilized to evaluate cervical instability. These may include the Sharp-Purser Test, which assesses for atlantoaxial instability, and imaging studies such as X-rays, CT scans, or MRI scans, which can provide detailed visualization of the cervical spine structures.
The Transverse Ligament Test is a valuable tool in assessing cervical instability, specifically the stability of the upper cervical spine. It helps to evaluate the integrity of the transverse ligament and the movement between the atlas and axis vertebrae. However, it is important to remember that this test should be performed by a trained professional and in conjunction with other clinical tests and imaging studies for a comprehensive evaluation of cervical instability.