Ligamentum flavum: Difference between revisions
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The combination of MRI and computed tomography seems the most useful for the precise diagnosis of OLF.<ref>J. Hanakita ,H. Suwa , F. Ohta , S. Nishi , H. Sakaida . [https://link.springer.com/article/10.1007/BF00593939 Neuroradiological examination of thoracic radiculo-myelopathy due to ossification of the ligamentum flavum] .Neuroradiology Jan 1990 :32 (1):38-42.</ref> | The combination of MRI and computed tomography seems the most useful for the precise diagnosis of OLF.<ref>J. Hanakita ,H. Suwa , F. Ohta , S. Nishi , H. Sakaida . [https://link.springer.com/article/10.1007/BF00593939 Neuroradiological examination of thoracic radiculo-myelopathy due to ossification of the ligamentum flavum] .Neuroradiology Jan 1990 :32 (1):38-42.</ref> | ||
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== References == | == References == | ||
Revision as of 05:39, 22 March 2019
Original Editor - Rachael Lowe
Top Contributors - Rachael Lowe, Kim Jackson, Sehriban Ozmen, Andeela Hafeez, WikiSysop, Ahmed Nasr, Admin and Evan Thomas
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 it`s 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 it`s flexible nature[1][2].
Despite the elastic and flexible nature of the ligament ,At neutral position the ligament has pretension preventing ligament from buckling. At lumbar vertebra this pretension is provided by that the traction and tension forces applied by muscles on Thoracolumbar fascia is transduced through supraspinous , interspinous ligaments to ligamentum flavum causing it`s pretension at 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]
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 lamnia below
On each side the ligament divides into two portions:
- The medial portion : passes to the back of the next lower lamina and cross the gap between the adjacent vertebrae fusing with interspinous ligament
- The lateral portion : passes in front of the fact 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]
- Their marked elasticity serves to preserve the upright posture and to assist the vertebral column in resuming it after flexion. It resists excess separation of adjacent vertebral lamina and prevents buckling of the ligament into the spinal canal during extension, which would cause canal compression.
- The lateral portion prevents the anterior capsule of the facet joint being nipped within the joint cavity during movement.
Pathology[edit | edit source]
The body goes through several changes as a person 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 with at same time increase in the thickness of collagen fibers ,These events favor deposition of Ca+2 in the ligament. Calcification of the ligament causes hypertrophy and to spinal canal stenosis when this happens patient can develop spinal stenosis (or a narrowing of the spinal canal) and a sometimes painful condition.
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]
there is little to no regeneration power of elastin tissue at ligamentum flavum thus loss of elastin tissue can`t be recovered again .
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]
- ↑ Nikolai Bogduk. Clinical and Radiological Anatomy of the Lumbar Spine 5th Edition.Churchill Livingstone: Elsevier. Feb 2012.
- ↑ 2.0 2.1 Vleeming A ,Mooney V . Movement, Stability & Lumbopelvic Pain 2nd Edition . Philadelphia.Churchill Livingstone .1st March 2007
- ↑ https://www.laserspineinstitute.com/back_problems/spinal_anatomy/spine/flavum/
- ↑ Park J B, Lee J K, Park SJ, Riew KD .Hypertrophy of ligamentum flavum in lumbar spinal stenosis associated with increased proteinase inhibitor concentration.The Journal of Bone and Joint Surgery-American . 2005 Dec:87(12):2750-7.
- ↑ https://www.laserspineinstitute.com/articles/ligamentum_flavum_articles/anatomy/281/
- ↑ J. Hanakita ,H. Suwa , F. Ohta , S. Nishi , H. Sakaida . Neuroradiological examination of thoracic radiculo-myelopathy due to ossification of the ligamentum flavum .Neuroradiology Jan 1990 :32 (1):38-42.
