Transverse Ligament Test

Transverse Ligament Test

Purpose of Test: The transverse ligament test assesses the integrity of the transverse ligament to resist anterior translation of C1 on C2.

It is crucial to screen the upper cervical ligaments when there is a question of cervical trauma.

Step 1: 0:20 With the patient lying supine, support their head with both hands, with your index finger tips over the posterior arch of the atlas (between the occipital protuberance and C2 spinous process). Provide an anterior force to C1 and hold this position for 15 seconds. Ask the patient to report and describe any symptoms.

A positive transverse ligament test is indicated by a soft endfeel or an INCREASE in symptoms (muscle spasm, nausea, vertigo, paresthesia, nystagmus, esophageal pressure).

A positive transverse ligament test indicates atlantoaxial instability due to decreased integrity of the transverse ligament and requires medical attention.

Evidence:

Wise and Shenk, 2011 ISC21.1.5 pp. 19-21
IFOMPT Cervical Screening Document