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Morphologic and histologic study of the ligamentum flavum in the thoraco-lumbar region

Étude morphologique et histologique du ligament jaune dans la région thoraco-lombaire

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Summary

The ligamentum flavum, of which there are only a few studies in the literature, has several features discussed in this work. On the macroscopic level, it has a metameric arrangement: it has two layers, superficial and deep, whose fibers are opposite, and it has close relations with the tendons of attachment of some spinal erector muscles. On the microscopic level, its structure is unique for a ligament, because of a predominance of elastic fibers, because of its intrinsic innervation at each level of the spine, and because this innervation grows poorer with increasing degeneration. The ligamentum flavum constitutes an active ligament, with an essential biomechanical role. Its injury is probably not without consequences, and therefore there are many technical problems about the surgical interlaminar approach.

Résumé

Le lig. jaune (ligamentum flavum), dont peu d'études sont rapportées dans la littérature, a plusieurs particularités mises en évidence dans ce travail. Sur le plan macroscopique, il a une disposition métamérique, il est composé de deux feuillets dont les fibres sont de direction opposée, il entretient des rapports étroits avec certains tendons d'insertion des mm. érecteurs du rachis. Sur le plan microscopique, sa structure est particulière pour un ligament, car y prédominent les fibres élastiques; une innervation lui est propre à chaque niveau vertébral, cette innervation s'appauvrit au fur et à mesure qu'augmente la dégénérescence ligamentaire. Le lig. jaune constitue un système ligamentaire actif, avec un rôle biomécanique essentiel. Le léser n'est sans doute pas sans conséquence, et cela pose des questions techniques concernant les abords chirurgicaux interlamaires.

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References

  1. Ahmed M, Bjurholm A, Kreibergs A, Schultsberg M (1993) Sensory and autonomic innervation of the facet joint in the rat lumbar spine. Spine 18: 2121–2126

    Google Scholar 

  2. Ashton IK, Ashton BA, Gibson SJ, Polak JM, Jaffray DC, Eisenstein SM (1992) Morphological basis for back pain: the demonstration of nerve fibers and neuropeptides in the lumbar facet joint capsule but not in ligamentum flavum. J Orthop Res 1: 72–78

    Google Scholar 

  3. Barrack RL, Whitecloud TS, Burke SW, Cook SD, Harding AF (1984) Proprioception in idiopathic scoliosis. Spine 9: 681–685

    Google Scholar 

  4. Behrin JF, Brigg CA (1988) Ligaments of the lumbar spine. Surg Radiol Anat 10: 211–219

    Google Scholar 

  5. Bogduk N, Wilson AS, Tynan W (1982) The human lumbar dorsal rami. J Anat 134: 383–397

    Google Scholar 

  6. Bogduk N (1983) The innervation of the lumbar spine. Spine 8: 286–293

    Google Scholar 

  7. Chazal J, Escande G, Guillot M, et al. (1980) Anatomie des ligaments du rachis. Éléments de biomécanique du rachis. 63° congrès de l'Association des Anatomistes. Bloc Santé, pp 151–167, 192–210

  8. Chazal J, Tanguy A, Bourges M, Gaurel G, Escande G, Guillot M, Vanneuville G (1985) Biomechanical properties of spinal ligaments and a histological study of the supraspinal ligament in traction. J Biomech 18: 167–176

    Google Scholar 

  9. Edgar MA, Ghadially JA (1976) Innervation of the lumbar spine. Clin Orthop 115: 35–41

    Google Scholar 

  10. Escande G, Gaurel G, Chazal J, Guillot M, Tanguy A, Vanneuville G (1980) Eléments de biomécanique vertébrale. Eléments de biomécanique du rachis. 63e Congrès de l'Association des Anatomistes. Bloc Santé, pp 82–112

  11. Goel VK, Voo LM, Weinstein JN (1988) Response of the ligamentous lumbar spine to cyclic bending loads. Spine 13: 294–300

    Google Scholar 

  12. Gracovetsky S, Farfan H, Lamy C (1981) The mechanism of the lumbar spine. Spine 3: 249–262

    Google Scholar 

  13. Groen GJ, Baljet B, Drukker J (1990) Nerves and nerve plexuses of the human vertebral column. Am J Anat 188: 282–296

    Google Scholar 

  14. Guillot M, Pionchon H, Pialat J (1988) Étude de l'innervation du rachis lombaire chez l'homme. Rev Rhum 5: 421–423

    Google Scholar 

  15. Hadley-Miller N, Mims B, Milewicz DM (1994) The potential role of the élastic fiber system in adolescent idiopathic scoliosis. J Bone Joint Surg [Am] 76-A: 1193–1206

    Google Scholar 

  16. Hirsch C, Ingelmark BE, Miller M (1963) The anatomical basis for low back pain: studies on the presence of sensory nerve endings in ligamentous, capsular and intervertebral disc structures in human lumbar spine. Acta Orthop Scand 33: 1–17

    Google Scholar 

  17. Jackson HC, Winkelmann RK, Bickel WH (1966) Nerve endings in the human lumbar spinal column and related structures. J Bone Joint Surg 48: 1272–1281

    Google Scholar 

  18. Jiang H, Russel G, Raso VJ, Moreau MJ, Hill DL, Bagnall KM (1995) The nature and distribution of the innervation of human supraspinal and interspinal ligaments. Spine 20: 869–876

    Google Scholar 

  19. Korkala O, Gronblad M, Liesi P, Kara-Harju E (1985) Immunohistochemical demonstration of nociceptors in ligamentous structures of the lumbar spine. Spine 10: 156–157

    Google Scholar 

  20. Lazorthes G (1972) Les branches postérieures des nerfs rachidiens et le plan articulaire vertébral postérieur. Ann Med Phys 15: 192–202

    Google Scholar 

  21. Maigne JY, Ayral X, Guerin-Surville H (1992) Frequency and size ossifications in the caudal attachments of the ligamentum flavum of the thoracic spine. Role of rotatory strains in their development. An anatomic study of 121 spines. Surg Radiol Anat 2: 119–124

    Google Scholar 

  22. Mykelbust JB, Pintar F, Maiman D (1988) Tensile strength of spinal ligaments. Spine 5: 526–531

    Google Scholar 

  23. Nachemson A, Evans JH (1968) Some mechanical properties of the third interlaminar ligament (ligamentum flavum). J Biomechanics 1: 211–220

    Google Scholar 

  24. Okada K, Oka S, Tohge K (1991) Thoracic myelopathy caused by ossification of the ligamentum flavum: clinicopathologic study and surgical treatment. Spine 16: 280–287

    Google Scholar 

  25. Olszewski AD, Yaszemski MJ, White AA (1966) Anatomy of the human lumbar ligamentum flavum. New observations and their surgical importance. Spine 20: 2307–2312

    Google Scholar 

  26. Panjabi MM, Goel VK, Takata K (1982) Physiological strains in lumbar spinal ligaments. An in vitro biomechanical study. Spine 7: 192–203

    Google Scholar 

  27. Parke WW, Watanabe R (1990) Adhesion of the ventral lumbar dura. An adjunct source of discogenic pain? Spine 15: 300–303

    Google Scholar 

  28. Pionchon H, Tommasi M, Pialat J (1986) Etude de l'innervation des ligaments rachidiens à l'étage lombaire. Bull Assoc Anat 210: 63–67

    Google Scholar 

  29. Poletti CE (1995) Central lumbar stenosis caused by ligamentum flavum; unilateral laminotomy for bilateral ligamentectomy: preliminary report of two cases. Neurosurg 37: 343–347

    Google Scholar 

  30. Putz R (1992) The detailed functional anatomy of the ligaments of the vertebral column. Ann Anat 174: 40–47

    Google Scholar 

  31. Ramani PS, Perry RH, Tomlinson BE (1975) Role of ligamentum flavum in the symptomatology of prolapsed lumbar intervertebral discs. J Neurol Neurosurg Psych 38: 550–557

    Google Scholar 

  32. Ramsey RH (1966) The anatomy of the ligamenta flava. Clin Orthop 44: 129–140

    Google Scholar 

  33. Rhalmi S, Yahia LH, Newman N, Isler M (1993) Immunohistochemical study of nerves in lumbar spine ligaments. Spine 18: 264–267

    Google Scholar 

  34. Rivard CH, Rhalmi S, Newman N, Yahia LH (1993) Étude morphologique de l'innervation des ligaments rachidiens de patients scoliotiques. Ann Chir 47: 869–873

    Google Scholar 

  35. Scoles PV, Linton AE, Larimer B, Levy ME, Digiovanni BF (1988) Vertebral body and posterior element morphology: the normal spine in middle life. Spine 13: 1082–1086

    Google Scholar 

  36. Tkaczuk H (1968) Tensile properties of human lumbar longitudinal ligaments. Acta Orthop Scand [Suppl 115]: 8–9

    Google Scholar 

  37. Vernet O, Frankhauser H, Schnyder P, Deruaz JP (1991) Cyst of the ligamentum flavum: report of six cases. Neurosurgery 29: 277–283

    Google Scholar 

  38. Yahia LH, Drovin G, Rivard CH (1986) Light and scanning electron microscopy of human spinal ligaments. Biomech Mater 55: 333–350

    Google Scholar 

  39. Yahia LH, Newman N, Rivard CH (1988) Neurohistology of lumbar spine ligaments. Acta Orthop Scand 59: 508–512

    Google Scholar 

  40. Yahia LH, Garzon S, Strykowski H, Rivard CH (1990) Ultrastructure of the human interspinous ligament and ligamentum flavum. A preliminary study. Spine 15: 262–268

    Google Scholar 

  41. Yahia LH, Newman N (1991) Innervation of spinal ligaments of patients with disc herniation. An immunohistochemical study. Pathol Res Pract 187: 936–938

    Google Scholar 

  42. Yekutiel M, Robin GC (1981) Proprioceptive function in children with adolescent idiopathic scoliosis. Spine 6: 560–566

    Google Scholar 

  43. Yong-Hing K, Reilly J, Kirkaldy-Willis WH (1976) The ligamentum flavum. Spine 1: 226–234

    Google Scholar 

  44. Yoshiba M, Shima K, Tanigushi Y, Tamaki T, Tanaka T (1992) Hypertrophied ligamentum flavum in lumbar spinal canal stenosis. Pathogenesis and morphologic and immunohistochemical observation. Spine 17: 1353–1360

    Google Scholar 

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Authors and Affiliations

  1. Department of Anatomy, University of Bordeaux II, 146, rue Léo-Saignat, F-33076, Bordeaux Cedex, France

    D. Viejo-Fuertes, D. Liguoro, D. Midy & J. Guerin

  2. Department of Pathologic Anatomy, Hospital Pellegrin, 1, Place Amélie Raba-Léon, F-33076, Bordeaux Cedex, France

    J. Rivel

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  1. D. Viejo-Fuertes
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  2. D. Liguoro
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Viejo-Fuertes, D., Liguoro, D., Rivel, J. et al. Morphologic and histologic study of the ligamentum flavum in the thoraco-lumbar region. Surg Radiol Anat 20, 171–176 (1998). https://doi.org/10.1007/BF01628891

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