Dentate ligament
- A white fibrous sheet
- Formed from pia mater
- Attached to the
- the lateral spinal cord to its dural coverings at 21 points along its length
- Spinal cord medially
- Medial border of the dentate ligament, which is attached to the pia mater between the dorsal and ventral rootlets along the length of each side of the spinal cord, presents a series of triangular toothlike processes on each side that are attached at intervals to the dura mater.
- Dura mater laterally.
- Often incorporated into the dural cuff around the vertebral artery at the site of dural penetration
- The most rostral attachment of the dentate ligament is located at the level of the foramen magnum, above where the vertebral artery pierces the dura.
- At the craniocervical junction, the dentate ligament is located between
- The vertebral artery and the ventral roots of C1 anteriorly
- The branches of the posterior spinal artery and the spinal accessory nerve posteriorly;
- The ligament courses behind the accessory nerve at that level, although the dentate ligament is located anterior to the accessory nerve at lower levels.
- The second triangular process is attached to the dura below the site at which the vertebral artery and the roots of C1 pierce the dura.
- Sectioning the upper two triangular processes will increase access anterior to the spinal cord.
- The first cervical nerve courses along the posteroinferior surface of the vertebral artery as it pierces the dura.
- The ventral root is located anterior to the dentate ligament, and the dorsal root, which is infrequently present, passes posterior to the dentate ligament.
- There are frequently communications between the C1 nerve root and the spinal accessory nerve.
Hoffman ligament
- Nonspecific descriptions of varying fibrous connective tissue bands in the epidural space, mainly mentioned in the lumbar region, that tether the dural sac to the posterior longitudinal ligament, the vertebral canal, and the ligamentum flavum
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