Dynamic canal encroachment of ligamentum flavum: an in vitro study of cadaveric specimens.
OBJECTIVE
In extension of the cervical spine, the ligamentum flavum (LF) may bulge and intrude into the vertebral canal and cause symptoms of myelopathy and/or radiculopathy in patients with canal stenosis. Knowledge of the relationship between the extension angle and the physiologic changes of the LF is important for a better understanding of the clinical symptoms. The current study was designed to demonstrate the dynamic correlativity of canal intrusion of the LF bulge with the extension angle of the cervical spine.


METHODS
With a novel method, the probe of the electrical resistance strain gauge was put into the cervical canals of 14 cadaveric specimens. The LF bulge distance of six segments (C2-C3 to C7-T1) and corresponding extension angles of every 5 degrees from 0 degrees to 45 degrees were collected. Angle-bulge curves were drawn.


RESULTS
In overextension (45 degrees ), C5-C6 had the biggest canal intrusion depth (3.478+/-0.527 mm), whereas the upper and lower segments declined gradually (C5-C6>C4-C5>C6-C7>C3-C4>C7-T1>C2-C3). The curves in all segments were sigmoidal, which demonstrated the dynamic change of LF, that is, during the process of extension, LF shortened and contracted first, after the original length was reached, it began to bulge and burst into the canal.


CONCLUSIONS
The current study has provided a method to measure inner canal kinematic changes in intact spinal specimens.
Gu
Rui
R
Department of Orthopedics, China-Japan Union Hospital of Jilin University, 2 Sendai Street, Changchun 130033, China. ccgurui@hotmail.com
Zhu
Qingsan
Q
Lin
Ye
Y
Yang
Xiaoyu
X
Gao
Zhongli
Z
Tanaka
Yasuhisa
Y
D000328:Adult; D000818:Animals; D002102:Cadaver; D002574:Cervical Vertebrae / Q000033:anatomy & histology* / Q000502:physiology*; D004548:Elasticity; D006801:Humans; D066298:In Vitro Techniques; D017843:Ligamentum Flavum / Q000033:anatomy & histology* / Q000502:physiology*; D008297:Male; D016059:Range of Motion, Articular / Q000502:physiology; D013115:Spinal Canal / Q000033:anatomy & histology* / Q000502:physiology*; D013314:Stress, Mechanical; D013904:Thoracic Vertebrae / Q000033:anatomy & histology / Q000502:physiology