Anthony M T Chau1, Nicholas Robert Pelzer2, Jacob Hampton2, Adam Smith2, Kevin A Seex3, Fiona Stewart3, Cristian Gragnaniello4. 1. Macquarie Neurosurgery, Australian School of Advanced Medicine, Macquarie University Hospital, Suite 201, Level 2, 2 Technology Place, Macquarie University, NSW 2109, Sydney, Australia; School of Medicine, University of New England, Armidale, NSW 2351, Australia. Electronic address: amtchau@gmail.com. 2. School of Medicine, University of New England, Armidale, NSW 2351, Australia. 3. Macquarie Neurosurgery, Australian School of Advanced Medicine, Macquarie University Hospital, Suite 201, Level 2, 2 Technology Place, Macquarie University, NSW 2109, Sydney, Australia. 4. Macquarie Neurosurgery, Australian School of Advanced Medicine, Macquarie University Hospital, Suite 201, Level 2, 2 Technology Place, Macquarie University, NSW 2109, Sydney, Australia; School of Medicine, University of New England, Armidale, NSW 2351, Australia.
Abstract
BACKGROUND CONTEXT: Cadaveric descriptions of the deep layer of the lumbar ligamentum flavum (LF), extending between contiguous borders of adjacent laminae and into the lateral spinal canal region are limited. PURPOSE: To provide detailed descriptions of the lumbar LF. STUDY DESIGN: Cadaveric dissection. METHODS: The deep ligamentum flava of 14 formalin-fixed human cadaver lumbar spines (140 levels) were examined to assess their laminar attachments and lateral extents in relation to the intervertebral foramen. RESULTS: The variable attachment of the deep layer of the LF with respect to the cephalad and caudad laminae was identified and described. At each successive caudal level of the lumbar spine, the deep layer appeared to become a more prominent feature of the posterior vertebral column, lining more of the laminae to which it is attached and encroaching further into the posteroinferior region of the intervertebral foramen at its lateral margins. CONCLUSIONS: We describe our observations of the deep LF in the human lumbar spine. These observations have clinical relevance for the interpretation of radiologic imaging and the performance of adequate decompression in the setting of spinal stenosis.
BACKGROUND CONTEXT: Cadaveric descriptions of the deep layer of the lumbar ligamentum flavum (LF), extending between contiguous borders of adjacent laminae and into the lateral spinal canal region are limited. PURPOSE: To provide detailed descriptions of the lumbar LF. STUDY DESIGN: Cadaveric dissection. METHODS: The deep ligamentum flava of 14 formalin-fixed human cadaver lumbar spines (140 levels) were examined to assess their laminar attachments and lateral extents in relation to the intervertebral foramen. RESULTS: The variable attachment of the deep layer of the LF with respect to the cephalad and caudad laminae was identified and described. At each successive caudal level of the lumbar spine, the deep layer appeared to become a more prominent feature of the posterior vertebral column, lining more of the laminae to which it is attached and encroaching further into the posteroinferior region of the intervertebral foramen at its lateral margins. CONCLUSIONS: We describe our observations of the deep LF in the human lumbar spine. These observations have clinical relevance for the interpretation of radiologic imaging and the performance of adequate decompression in the setting of spinal stenosis.
Authors: Adam Smith; Filippo Gagliardi; Nicholas Robert Pelzer; Jacob Hampton; Anthony Minh Tien Chau; Fiona Stewart; Pietro Mortini; Cristian Gragnaniello Journal: J Spine Surg Date: 2015-12