Ligamentum Flavum and Related Spinal Ligaments

Fig. 32.1
Posterior ligaments of interest in lumbar spinal blockade. Different ligaments may be traversed to reach the spinal canal: (a) The supraspinal ligament (ssl), a slender structure that extends between the tips of adjacent spinous processes (sp); (b) The interspinal ligament (isl), a band of collagen fibers occupying the interspinal space; (c) The ligamentum flavum (lf), the Latin name of which refers to its yellowish color due to its high content of elastin fibers. (d) The trajectory of a needle is visualized in this model by applying a partial transparent effect to the interspinal ligament. It is generally accepted that the sign of loss of resistance results from traversing the ligamentum flavum, and aids in locating the epidural space. The three-dimensional (3D) models of the lumbar spine are built from axial (ad) and sagittal (ac) T2-weighted reference images. ds dural sac, L3 L3 vertebra, L4 L4 vertebra, L5 L5 vertebra


Fig. 32.2
The ligamentum flavum (lf) is a paired quadrangular structure with a metameric disposition, seen in dorsal view (a), dorsolateral view (b), and ventral views (c, d). The left and right ligamenta flava tend to fuse in the middle, but a gap may persist at some vertebral levels, as represented in this 3D model (arrow, c). This ligament is attached cranially to the inner surface of the vertebral lamina (vl) of the contiguous superior vertebra, as well as to the outer surface of the lamina from the contiguous inferior vertebra. It occupies the interlaminar space and keeps close relationships with the posterior epidural fat (pef), the dural sac (ds), and the zygapophyseal joint (zj) (d). To demonstrate its characteristic spatial orientation and anatomical relations, a partial transparent effect has been applied to the L3 vertebra in (a, b). The posterior vertebral arch is shown by cutting the model through the vertebral pedicles (vp), and a T2-weighted axial image (ac) or a T1-weighted axial image (d) is used as reference. L4 L4 vertebra, ss subarachnoid space

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Sep 18, 2016 | Posted by in ANESTHESIA | Comments Off on Ligamentum Flavum and Related Spinal Ligaments
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