Ligamentum Flavum Thickening and Low Back Pain

This ligament is often overlooked in patients with low back pain. It can be hypertrophic as a result of elastic fibers misalignment along with the development of calcification over time.

Calcification was frequently observed in elderly patients and those with cauda equina symptoms.

Chondroid cells were frequently observed in patients with spondylolisthesis, and patients with ossification had a greater translation percentage, suggesting the involvement of mechanical load in ossification of ligaments.

The pathologic findings were significantly related to the clinical features, and these findings will be profitable for understanding the pathogenesis of degenerative lumbar disease.

As stress increases on the ligamenta flava, their cells become inflamed (hypertrophy) and begin to ossify or thicken.

This increase in size and decrease in elasticity occasionally combine to reduce the area available for nerve roots and the spinal cord to pass (spinal stenosis).

References:

• Altun I. et Yuksel K. (2017) Histopathological Analysis of Ligamentum Flavum in Lumbar Spinal Stenosis and Disc Herniation. https://www.ncbi.nlm.nih.gov/pubmed/28243372#

• Okuda T. et al (2004) The pathology of ligamentum flavum in degenerative lumbar disease. Spine (Phila Pa 1976). Aug 1;29(15):1689-97.