Ligamentum flavum hypertrophy

Introduction The ligamentum flavum is not continuous, and the ligamentum flavum on both sides has a fissure on the midline. It starts from the anterior and posterior aspect of the superior lamina and ends on the posterior top of the lower lamina. Hypertrophy of the ligamentum flavum may be related to factors such as chronic degeneration, trauma, inflammation, and metabolic disorders. It can occur at any age and progresses rapidly and to a greater extent. More often due to long-term sitting or bending work lead to hypertrophy, often causing spinal stenosis, severe cases of low back pain and lower limb pain and numbness, should go to the hospital for CT or MRI examination, according to the light and heavy choice of treatment options.

Cause

The etiology or pathogenesis of hypertrophy of the ligamentum flavum is unclear and may be related to factors such as chronic degeneration, trauma, inflammation, and metabolic disorders. When the lumbar vertebrae degenerate, the stress on the ligamentum flavum is very high, and the elastic fibers will be denatured or broken. The long-term damage and repair process will inevitably cause fibrosis of the ligamentum flavum, which will eventually lead to calcification of the ligamentum flavum.

an examination

Related inspection

Spinal MRI examination of bone and joint soft tissue CT examination

Hypertrophy of the ligamentum flavum is one of the main causes of lumbar spinal stenosis, which often constitutes the cause of lumbar spinal stenosis together with coagulation and hyperplasia of the articular process and thickening of the lamina. Lumbar spinal stenosis caused by simple ligamentum flavum hypertrophy is rare in clinical practice, but must be given high priority. Degenerative ligamentum flavum is more common in the elderly, with a long course of disease, and may have an acute aggravation process. Occurs between the lumbar 4 ~ lumbar 5 lamina, so that the cauda equina and nerve roots are oppressed. The nerve root can be affected bilaterally or unilaterally. Clinical symptoms are similar to those of lumbar spinal stenosis. Often the lower back pain is mainly relieved or disappeared after rest, and there may be neurogenic intermittent claudication. MRI diagnosis of ligamentum flavum can be complementary to CT, because CT can detect the calcification of the ligamentum flavum, small facet joint hyperplasia and other reasons, and the sagittal plane of MRI can directly show the lesion appearance for the ligamentum flavum involving multiple spinal canals. .

Differential diagnosis

Differential diagnosis of hypertrophy of the ligamentum flavum: The neurological symptoms caused by hypertrophy of the ligamentum flavum are often misdiagnosed clinically, such as cerebrovascular disease, myelitis, spinal cord tumor, peripheral neuritis, etc., which need to be carefully identified. Hypertrophy of the ligamentum flavum is one of the main causes of lumbar spinal stenosis, which often constitutes the cause of lumbar spinal stenosis together with coagulation and hyperplasia of the articular process and thickening of the lamina.

Lumbar spinal stenosis caused by simple ligamentum flavum hypertrophy is rare in clinical practice, but must be given high priority.

Degenerative ligamentum flavum is more common in the elderly, with a long course of disease, and may have an acute aggravation process. Occurs between the lumbar 4 ~ lumbar 5 lamina, so that the cauda equina and nerve roots are oppressed. The nerve root can be affected bilaterally or unilaterally. Clinical symptoms are similar to those of lumbar spinal stenosis. Often the lower back pain is mainly relieved or disappeared after rest, and there may be neurogenic intermittent claudication. When MRI is diagnosed with hypertrophy of the ligamentum flavum, it can be complementary to CT. Because CT can detect the calcification of the ligamentum flavum and the proliferation of facet joints, the sagittal plane of MRI can directly show the lesions of the ligamentum flavum involving multiple spinal canals. .

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