Factors Associated With the Thickness of the Ligamentum Flavum

Altınkaya, Naime; Yıldırım, Tülin; Demır, Şenay; Alkan, Özlem; Sarica, Feyzi Birol

doi:10.1097/brs.0b013e318203e2b5

Cited by 88 publications

(55 citation statements)

References 13 publications

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“…This observation agrees with another study. 11 The pathogenesis of thickening of the LF is not well understood. Some studies have asserted that age-related fibrosis or decrease in the elastin-to-collagen ratio of the LF, along with hypertrophy of the LF, is associated with lumbar spinal stenosis, while others argued that the LF bulges inside the spinal canal and compresses nerve tissues.…”

Section: Introductionmentioning

confidence: 99%

“…1,10 The "thickening" is the buckling of the LF into the spinal canal after disc collapse. 11 To evaluate this theory, the relationship between the thickness of the LF and intervertebral disc degeneration, disc height at L2-L3, L3-L4, L4-L5, and L5 -S1 were examined; it was found that the LF was generally thicker in patients with grades IV to V degeneration than in those…”

Section: Introductionmentioning

confidence: 99%

“…7 Some differences were found among the LF thicknesses at each level, this finding is in agreement with previous studies. 7,11,12 The thickest LF measurement was at L4-L5 and L5-S1. LF was thicker in females than males, this finding disagree with previous studies.…”

Section: Introductionmentioning

confidence: 99%

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Assessment of ligamentum flavum thickness correlation with demographic variables and disc degeneration in Erbil governorate population sample

Akreyi

Awdish

2012

ZJMS

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Background and objectives:This study aimed to investigate the correlation between the ligamentum flavum thickness and age, sex, body mass index and type of disc degeneration. Method: 126 consecutive patients were examined prospectively. The sample included all the patients who had an MRI examination after they presented to Rizgary teaching hospital complaining of lower back and/or leg pain. The LF thickness was measured by using lumbo-sacral spine MRI. Results: The mean thickness of LF was more at L4-L5 (right: 0.27 mm, left 0.25 mm), L5-S1 (right: 0.25 mm, left 0.25 mm) levels, and was thicker on the right side. LF was thicker in females than males with a statistically significant measurement at L2-L3, L3-L4 and L4-L5 levels. The mean thickness of LF was more at older age group than the younger age groups, and the results were statistically different at left side of L2-L3 and right side of L4-L5 level. Thickness of LF was more among those with higher BMI for all levels except for L5-S1. In most cases, LF was thicker in patients with advanced disc degeneration. Conclusion: Thickening of the LF is associated to some extent with sex, age, BMI and disc degeneration. Thickening of the LF is potentially due to its buckling into the spinal canal secondary to disc degeneration more than to LF hypertrophy. Further research is needed to confirm these associations.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Assessment of ligamentum flavum thickness correlation with demographic variables and disc degeneration in Erbil governorate population sample

Akreyi

Awdish

2012

ZJMS

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“…It is a major factor in spinal canal stenosis [6]. The pathogenesis of LF thickening has been linked to reductions in the elastin-to-collagen ratio of LF or age-related fibrosis, and is associated with LSS [6].…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, the LF covers a considerable portion of the lateral and posterior walls of the spinal canal. Thickening of the ligamentum flavum can compress the nerve root and dural sac, diminishing the diameter of the spinal canal, and contributing to sciatica and lower back pain [6]. However, the findings from conventional MRI are not always compatible with the clinical symptoms of spinal stenosis.…”

Section: Introductionmentioning

confidence: 98%

Clinical symptoms of lumbar spinal stenosis associated with morphological parameters on magnetic resonance images

et al. 2015

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Decreased elastic fibers and increased proteoglycans in the ligamentum flavum of patients with lumbar spinal canal stenosis

Yabe

Hagiwara

Tsuchiya

et al. 2015

Journal Orthopaedic Research

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Elastic fibers and proteoglycans are major components of the extracellular matrix and their changes have been reported in some pathological conditions. Further, recent studies have indicated that some glycosaminoglycans and proteoglycans inhibit elastic fiber assembly. The purpose of this study was to investigate changes of the elastic fibers and proteoglycans in the ligamentum flavum and analyze their relationships to thickening of the ligamentum flavum from lumbar spinal canal stenosis (LSCS). Ligamentum flavum samples were collected from 20 patients with LSCS (thickened flavum group) and 10 patients with lumbar disc herniation (non-thickened flavum group) as a control. Elastica-Masson staining and alcian blue staining were used to compare the relationship between the changes in the elastic fibers and proteoglycans. Gene and protein expressions of the elastic fibers and proteoglycans were analyzed by quantitative reverse transcription polymerase chain reaction and immunohistochemistry. Histological changes indicated that proteoglycans mainly increased on the dorsal side of the ligamentum flavum in accordance with the decreased elastic fibers in the thickened flavum group. The gene and protein expressions of fibrillin-2 and DANCE were significantly lower and decorin, lumican, osteoglycin, and versican were significantly higher in the thickened flavum group. Our study shows that elastic fibers decrease and proteoglycans increase in the thickened ligamentum flavum. Decreased gene expression of elastogenesis and disrupted elastic fiber assembly caused by increased proteoglycans may lead to a loss of elasticity in the thickened ligamentum flavum. Decreased elasticity may cause buckling of the tissue, which leads to thickening of the ligamentum flavum. ß

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Factors Associated With the Thickness of the Ligamentum Flavum

Cited by 88 publications

References 13 publications

Assessment of ligamentum flavum thickness correlation with demographic variables and disc degeneration in Erbil governorate population sample

Assessment of ligamentum flavum thickness correlation with demographic variables and disc degeneration in Erbil governorate population sample

Clinical symptoms of lumbar spinal stenosis associated with morphological parameters on magnetic resonance images

Decreased elastic fibers and increased proteoglycans in the ligamentum flavum of patients with lumbar spinal canal stenosis

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