1.Quantitative Histological Analysis of Ligamentum Flavum
Mantu JAIN ; Mukund Namdev SABLE ; Amit TIRPUDE
Asian Spine Journal 2018;12(2):388-389
No abstract available.
Ligamentum Flavum
2.Ultrastructural Differences between Inner and Outer Layers of Human Lumbar Ligamentum Flavum.
You Sam WON ; Seung Min LEE ; Chun Sik CHOI ; Moon Bae JU ; Whan EOH ; Jong Hyun KIM ; Yun Kwan PARK ; Jung Keun SUH
Journal of Korean Neurosurgical Society 2000;29(5):599-603
No abstract available.
Humans*
;
Ligamentum Flavum*
3.Thoracic Myelopathy and Radiculomyelopathy due to Ossification of the Ligamentum Flavum: A Cases Report.
Sang Dae LEE ; Dong Youl RHEE ; Young Gyun JEONG ; Hyuck PARK ; Bong Soo CHO ; Soo Young KIM
Journal of Korean Neurosurgical Society 2000;29(10):1377-1382
No abstract available.
Ligamentum Flavum*
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Spinal Cord Diseases*
4.Ultrasonographic Measurement of the Ligamentum Flavum Depth; Is It a Reliable Method to Distinguish True and False Loss of Resistance?.
Michael Haejin PAK ; Won Hyung LEE ; Young Kwon KO ; Sang Young SO ; Hyun Joong KIM
The Korean Journal of Pain 2012;25(2):99-104
BACKGROUND: Previous studies have shown that if performed without radiographic guidance, the loss of resistance (LOR) technique can result in inaccurate needle placement in up to 30% of lumbar epidural blocks. To date, no study has shown the efficacy of measuring the depth of the posterior complex (ligamentum flavum, epidural space, and posterior dura) ultrasonographically to distinguish true and false LOR. METHODS: 40 cervical epidural blocks were performed using the LOR technique and confirmed by epidurograms. Transverse ultrasound images of the C6/7 area were taken before each cervical epidural block, and the distances from the skin to the posterior complex, transverse process, and supraspinous ligament were measured on each ultrasound view. The number of LOR attempts was counted, and the depth of each LOR was measured with a standard ruler. Correlation of false and true positive LOR depth with ultrasonographically measured depth was also statistically analyzed. RESULTS: 76.5% of all cases (26 out of 34) showed false positive LOR. Concordance correlation coefficients between the measured distances on ultrasound (skin to ligamentum flavum) and actual needle depth were 0.8285 on true LOR. Depth of the true positive LOR correlated with height and weight, with a mean of 5.64 +/- 1.06 cm, while the mean depth of the false positive LOR was 4.08 +/- 1.00 cm. CONCLUSIONS: Ultrasonographic measurement of the ligamentum flavum depth (or posterior complex) preceding cervical epidural block is beneficial in excluding false LOR and increasing success rates of cervical epidural blocks.
Epidural Space
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Ligaments
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Ligamentum Flavum
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Needles
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Skin
5.Focal Ligamentum Flavum Hypertrophy with Ochronotic Deposits: An Unusual Cause for Neurogenic Claudication in Alkaptonuria.
Rajesh REDDY ; Mudumba VIJAYASARADHI ; Debabrat BISWAL
Asian Spine Journal 2012;6(2):148-151
Neurogenic claudication resulting from focal hypertrophy of the ligamentum flavum in the lumbar spine due to ochronotic deposits has not been reported till date. The authors discuss one such case highlighting the pathogenesis, histological and radiological features. Salient features of management are also emphasized upon.
Alkaptonuria
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Hypertrophy
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Ligamentum Flavum
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Spinal Stenosis
;
Spine
6.Validity of Repeated MRI in Degenerative Lumbar Disease with Conservative Management.
Ju Oh KIM ; Bong Ju PARK ; Byung Wan CHOI ; Kyung Jin SONG ; Byung Ryeul CHOI ; Yun Hyeok YANG
The Journal of the Korean Orthopaedic Association 2009;44(6):604-612
PURPOSE: This study examined the value and indications of repeated MRI in degenerative lumbar diseases under conservative management by comparing the primary MR and repeated MR images with respect to the symptomatic and radiological changes. MATERIALS AND METHODS: Seventy patients with degenerative lumbar disease under conservative management underwent repeat MRI. Five MRI findings, including disc, foramen, facet joint, nerve root, and ligamentum flavum, were used to examine the difference between the initial and repeat MRI. The severity was graded using a four-point scale for each item. The patients were divided into 3 groups in order to compare the radiological changes and symptomatic changes, as follows; Group I no change from the initial symptoms (38 cases), Group II aggravation of the initial pain (18 cases), and Group III aggravation of the initial neurology or the development of a new neurology (14 cases). RESULTS: The mean scores of each item the disc, foramen, facet joint, nerve root and ligamentum flavum increased from 1.76, 1.31-1.79, 1.71, and 1.47, respectively, to 1.90, 1.47, 1.80, 1.79, and 1.53, respectively. Group III showed the greatest proportion of cases with an increasing grading score (78%, 11 cases) only the disc was significant. CONCLUSION: Repeat MRI in degenerative lumbar disease under conservative management was found to be valuable only in cases with aggravated neurological symptoms, and was not relevant in cases with persistent symptoms or aggravated pain alone.
Humans
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Ligamentum Flavum
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Neurology
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Zygapophyseal Joint
7.Compressive Myelopathy due to Ossification of Ligamentum Flavum in a Patient with Primary Hypoparathyroidism.
Kang Wook YOON ; Hak Young RHEE ; Tae Beom AHN ; Sung Sang YOON ; Dae Il CHANG ; Kyung Cheon CHUNG
Journal of the Korean Neurological Association 2005;23(5):730-731
No abstract available.
Humans
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Hypoparathyroidism*
;
Ligamentum Flavum*
;
Spinal Cord Compression*
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Spinal Cord Diseases
8.Thickness of the Ligamentum Flavum: Correlation with Age and Its Asymmetry-An Magnetic Resonance Imaging Study.
Vrushali Subhash KOLTE ; Seema KHAMBATTA ; Medha Vijay AMBIYE
Asian Spine Journal 2015;9(2):245-253
STUDY DESIGN: A retrospective radiological study of the ligamentum flavum (LF). PURPOSE: This study is an attempt to measure and compare the thickening of the LF on both the sides with the use of magnetic resonance imaging, to investigate if there is a predominant tendency to thicken a specific side and also to determine if a correlation between the thickening of the LF and increasing age exists. OVERVIEW OF LITERATURE: Even though many studies measured the thickness of the LF, very few have compared it on each side, or determined its correlation with age. METHODS: The thickness of LF was measured at the L3-4, L4-5, L5-S1 levels on both sides using the magnetic resonance images of 200 patients (n=1,200). The sample population was divided into three groups: 21-40 years, 41-60 years, and 61-80 years. The data was analyzed statistically, comparing the thickness of LF on both sides and in various age-groups. RESULTS: The thickness of the LF was found to increase with age; however, there were several younger instances with thicknesses >4 mm. The mean thickness of the right LF at different spinal levels was measured (L3-L4=3.38+/-0.94 mm, L4-L5=3.70+/-1.16 mm, and L5-S1=3.65+/-1.16 mm) while the mean thickness of the left LF was higher (L3-L4=3.52+/-0.99 mm, L4-L5=3.84+/-1.12 mm, and L5-S1=3.78+/-1.24 mm). CONCLUSIONS: The LF thickness does not appear to have any side dominance; however, it tends to thicken with increasing age.
Humans
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Ligamentum Flavum*
;
Magnetic Resonance Imaging*
;
Retrospective Studies
9.Radiological Significance of Ligamentum Flavum Hypertrophy in the Occurrence of Redundant Nerve Roots of Central Lumbar Spinal Stenosis.
Junseok W HUR ; Junho K HUR ; Taek Hyun KWON ; Youn Kwan PARK ; Hung Seob CHUNG ; Joo Han KIM
Journal of Korean Neurosurgical Society 2012;52(3):215-220
OBJECTIVE: There were previous reports of redundant nerve roots (RNRs) focused on their clinical significance and pathogenesis. In this study, we investigated the significant radiologic findings that correlate with RNRs occurrence. These relations would provide an advanced clue for clinical significance and pathogenesis of RNRs. METHODS: Retrospective research was performed with data from 126 patients who underwent surgery for central lumbar spinal stenosis (LSS). Finally, 106 patients with common denominators (inter-observer accuracy : 84%) were included on this study. We divided the patients into two groups by MRI, patients with RNRs and those with no RNRs (NRNRs). Comparative analyses were performed with clinical and radiologic parameters. RESULTS: RNRs were found in 45 patients (42%) with central LSS. There were no statistically significant differences between the two groups in severity of symptoms. On the other hand, we found statistically significant differences in duration of symptom and number of level included (p<0.05). In the maximal stenotic level, ligamentum flavum (LF) thickness, LF cross-sectional area (CSA), dural sac CSA, and segmental angulation are significantly different in RNRs group compared to NRNRs group (p<0.05). CONCLUSION: RNRs patients showed clinically longer duration of symptoms and multiple levels included. We also confirmed that wide segmental angulation and LF hypertrophy play a major role of the development of RNRs in central LSS. Together, our results suggest that wide motion in long period contribute to LF hypertrophy, and it might be the key factor of RNRs formation in central LSS.
Hand
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Humans
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Hypertrophy
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Ligamentum Flavum
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Retrospective Studies
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Spinal Stenosis
10.Dynamic Lumbar Spinal Stenosis : The Usefulness of Axial Loaded MRI in Preoperative Evaluation.
Kyung Chul CHOI ; Jin Sung KIM ; Byungjoo JUNG ; Sang Ho LEE
Journal of Korean Neurosurgical Society 2009;46(3):265-268
Two cases of dynamic lumbar spinal stenosis were identified by the authors using axial loaded magnetic resonance image (MRI). In both cases, the patients presented with neurogenic claudication but MRI in decumbency showed no definite pathologic condition associated with their symptoms. In contrast, axial loaded MRI demonstrated constrictive spinal stenosis and a significantly decreased dural sac caused by epidural fat buckling and thickening of the ligamentum flavum in both cases. In the second case, a more prominent disc protrusion was also demonstrated compared with decumbent MRI. After decompressive surgery, both patients had satisfactory outcomes. Axial loaded MRI can therefore give decisive information in dynamic spinal disorders by allowing simulation of an upright position.
Humans
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Ligamentum Flavum
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Magnetic Resonance Spectroscopy
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Spinal Stenosis