Ligamentum flavum: Difference between revisions

Description[edit|edit source]

The ligamenta flavum is a short but thick ligament that connects the laminae of adjacent vertebrae from C2 to S1 and is considered a medial ward continuation of the fact joint . It consists of 80% elastin fibers and 20% collagen fibers.This high percentage of elastin fibers provides the ligament it's yellow color and flexible nature^[1][2].

Despite the elastic and flexible nature of the ligament, at neutral position, the ligament haspretensionpreventing it from buckling.At lumbar vertebrathis pretension is provided by the traction and tension forces applied by muscles on the Thoracolumbar fascia by the supraspinous , interspinous ligaments to ligamentum flavum causing pretension in the neutral position (interspinous_supraspinous thoracolumbar ligamentous complex )^[2]

At each intersegmental level the ligamentum flavum is a paired structure being represented symmetrically on both sides.

In the neck region the ligaments are thin, but broad and long; they are thicker in the thoracic region, and thickest in the lumbar region.

Attachments[edit|edit source]

The ligament flavum arises from the lower half of the anterior surface of the lamina above and attaches to the posterior surface and upper margin of the lamina below, forming a cup-like grasp on the upper border of the lamina below.

On each side the ligament divides into two portions:

• The medial portion :passes to the back of the next lower lamina and across the gap between the adjacent vertebrae fusing with theinterspinousligament
• The lateral portion:passes in front of the facet joint where it attaches to the anterior aspect of the inferior and superior articular processes and forms the anterior capsule. The most lateral fibers extend beyond the superior articular process to the pedicle below.

Function[edit|edit source]

The marked elasticity serves to preserve the upright posture and to assist the vertebral column in resuming it's shape after flexion. It resists excessive separation of the adjacent vertebral lamina and prevents buckling of the ligament into the spinal canal during extension, preventing canal compression. The lateral portion of the ligament prevents the anterior capsule of the facet joint being nipped within the joint cavity during movement.

Pathology[edit|edit source]

作为人的身体经历一些变化ages. Some of these changes occur because of the continued wear that is placed on the body over long periods of time. The neck and back are especially susceptible to these changes since they are responsible for supporting the majority of the body’s weight and movements.over time,

Ligamentum flavum can lose strength and elasticity, causing it to thicken and buckle towards the spinal column this is due to loss of elastic fibers which at same time increase in the thickness of collagen fibers ,These events cause deposition of Ca⁺²in the ligament. Calcification of the ligament causes hypertrophy and can lead to spinal canal stenosis (narrowing of the spinal canal) which can sometimes cause pain.

If the ligamentum flavum buckles to the point that it impinges a spinal nerve, a patient may experience the following symptoms of spinal stenosis:

• Weakness
• Numbness
• Localized pain
• Radiating pain (depending on the location of the spinal stenosis, the pain could radiate into the shoulders, arms, ribs or legs)^[3]

Hypertrophy of this ligament may cause spinal stenosis because it lies in the posterior portion of the vertebral canal. Increased expression of TIMP-2 in ligamentum flavum fibroblasts is associated with fibrosis and hypertrophy of the ligamentum flavum in patients with spinal stenosis.^[4]

Many causes of neck and back pain are directly related to the ligamentum flavum. Though the anatomy of the spine is quite complex, treating conditions that affect it does not have to be.^[5]不幸的是,几乎没有再生power of elastin tissue at ligamentum flavum, loss of elastin tissue cannot be recovered.

Examination[edit|edit source]

The combination of MRI and computed tomography seems the most useful for the precise diagnosis of OLF.^[6]

References[edit|edit source]