The Surgical Anatomy and Pathology of the Supraspinous and Interspinous Ligaments of the Lumbar Spine with Special Reference to Ligament Ruptures

Rissanen, P

doi:10.3109/ort.1960.31.suppl-46.01

Cited by 61 publications

(63 citation statements)

References 34 publications

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“…Specific studies on the architecture and structure of these ligaments at the lumbar level have been published by Voena [1956Voena [ , 1957, Scapinelli [1958aScapinelli [ , 1960Scapinelli [ , 1988Scapinelli [ , 1989, Rissanen [1960], Heylings [1978], Prestar [1982] and Prestar et al [1985], reporting a predominant posterocranial arrangement of the bundles.…”

Section: Introductionmentioning

confidence: 99%

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The Lumbar Interspinous Ligaments in Humans: Anatomical Study and Review of the Literature

Scapinelli¹,

Stecco²,

Pozzuoli³

et al. 2006

Cells Tissues Organs

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In textbooks of human anatomy and atlases of spinal surgery, the lumbar interspinous ligaments are described and illustrated in various and often conflicting ways. Thirty-four lumbar vertebral columns (19 males, 15 females, range 17–92 years old), sampled at autopsy, were studied by dissection and macroscopic analysis. The orientation of the fibre bundles was evaluated in the sagittal plane by tracing a reference line parallel to the cranial border of the spinous process, and the degree of bundle tilting with reference to this line was measured in the ventral, middle and dorsal parts of the ligament. Histological and immunohistochemical (anti-S100) studies of the ligaments, on sagittal, frontal, and transversal planes, were also carried out. In vivo radiological validation was performed in 25 patients by MR and CT imaging. Macroscopically, the interspinous ligaments are consistently composed of bundles of fibres arranged in a characteristic pattern. Together, they present an oblique orientation from anterior to posterior in a caudal-cranial direction. In their ventral part the bundles form a slight curve with a posterior-inferior concavity. In the middle part, the bundles are thicker and arranged in an italic S shape with a mean degree of tilting of 52 ± 14, 21 ± 12 and 50 ± 17 in the anterior, intermediate and posterior subzones of the L2–L3 ligaments and of 32 ± 14, 11 ± 9 and 18 ± 11 in the anterior, intermediate and posterior subzones of the L4–L5 level. The dorsal part consists of obliquely ascending bundles of fibres mostly converging in the supraspinous ligament. Histologically, these ligaments are mainly composed of collagen fibres, whereas the elastic fibres are ubiquitous, although mostly concentrated in the ventral part, which is closely linked to the yellow ligament. The interspinous ligament is well supplied by small blood vessels and sensory nerves, the latter particularly in its dorsal part and on its lateral surfaces. According to collected data, the structure of the interspinous ligaments reflects their function, i.e., the italic S-shaped course of the fibrous bundles represents an available reserve of length in a poorly elastic ligament.

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Section: Introductionmentioning

confidence: 99%

“…The interspinous ligaments have recently been involved in the pathogenesis of disc herniation [Rissanen, 1960;Yahia and Newman, 1989], spinal rigidity in the elderly [Scapinelli, 1989], lumbago [Maigne et al, 1996] and vertebral instability [Fujiwara and Tamai, 2000].…”

Section: Introductionmentioning

confidence: 99%

The Lumbar Interspinous Ligaments in Humans: Anatomical Study and Review of the Literature

Scapinelli¹,

Stecco²,

Pozzuoli³

et al. 2006

Cells Tissues Organs

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“…The lower fibres were seen to blend with the supra-spinous ligament as well as with the thick thoraco-lumbar fascia covering the erector spinae muscle bi-laterally. Rissanen (1960) in his exhaustive study put forward certain interesting anatomic observations about the ISL. These observations were based on dissection of the ISL in 306 specimens that included cadavers ranging from foetal to 90 years age group specimens, with good numerical representations from within the range.…”

Section: Resultsmentioning

confidence: 99%

Anatomy of Lumbar Interspinous Ligaments: Attachment, Thickness, Fibre Orientation and Biomechanical Importance

Mahato

2013

Int. J. Morphol.

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SUMMARY:Literature related to the study of interspinous ligament in the lumbar region is sparse. Very few studies have elucidated the fibre orientation of this ligament at different lumbar levels. Male (19) and female (6) cadavers were dissected to expose the interspinous ligaments beneath all the lumbar vertebrae. Fibre attachments and directions were observed at all lumbar interspinous spaces. Thicknesses of the ligaments were measured at all levels. Interspinous ligament fibres were found to be oriented differently in the lumbar inter-spinous spaces. In the upper spaces the fibres were more horizontal. In the spaces beneath L3 and L4, fibres were curved and extended postero-superiorly. Fibres were thicker in the ligaments at the lower spaces in comparison to the upper ones. The mean thicknesses presented as: Upper (0.22 mm); Middle (0.37 mm) and L5-S1 (0.72 mm). Ligaments in the females were slightly thinner in comparison to the males. Fibres of inter-spinous ligaments were also found to attach to the inner aspects of the supraspinous ligament. Ligaments at L5-S1 junction were relatively vertical and stronger. None of the specimen demonstrated absence or cavitations of these ligaments except in a case with bi-laminar ligament at the L3-L4 level. The anatomy of the interspinous ligaments points to their probable role in graded restricting of acute flexion at the lumbar spine.

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“…In fact, it has been shown that pain improves after surgical excision of the spinous process [2] or the injection of local anesthetic agents [8]. However, the possibility has been raised that Baastrup's disease may not actually be a disease entity, but is rather just one of a spectrum of degenerative spinal diseases [2,7,10], because it is usually associated with various degenerative spinal pathologies [2,7].…”

Section: Introductionmentioning

confidence: 99%

Posterior epidural fibrotic mass associated with Baastrup’s disease

et al. 2010

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A few reports have demonstrated rare cases of Baastrup's disease that involve epidural cysts that cause dural compression. However, there have been no reports of a midline epidural fibrotic mass being associated with Baastrup's disease. A 60-year-old man presented with neurogenic claudication that had lasted for 5 years. Radiography showed anterolisthesis at the L4-L5 level, magnetic resonance imaging demonstrated severe stenosis due to a posterior noncystic mass, and the linear fluid signal tracked into the posterior epidural space at the L4-L5 level. A cleft in the ligamentum flavum was identified by probe at surgery, and this enabled the probe to be inserted into the epidural space without excising ligamentum flavum. Histological analysis showed that the fibrotic mass consisted of a collagen matrix that had a cystic component and exhibited a peripheral inflammatory reaction. This report shows that it is possible for an extended epidural cystic mass that occurs in Baastrup's disease to change over time through peripheral inflammation into a cyst-containing fibrotic mass.

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The Surgical Anatomy and Pathology of the Supraspinous and Interspinous Ligaments of the Lumbar Spine with Special Reference to Ligament Ruptures

Cited by 61 publications

References 34 publications

The Lumbar Interspinous Ligaments in Humans: Anatomical Study and Review of the Literature

The Lumbar Interspinous Ligaments in Humans: Anatomical Study and Review of the Literature

Anatomy of Lumbar Interspinous Ligaments: Attachment, Thickness, Fibre Orientation and Biomechanical Importance

Posterior epidural fibrotic mass associated with Baastrup’s disease

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