Lateral extent and ventral laminar attachments of the lumbar ligamentum flavum: cadaveric study.
BACKGROUND
Cadaveric descriptions of the deep layer of the lumbar ligamentum flavum (LF), extending between contiguous borders of adjacent laminae and into the lateral spinal canal region are limited.


OBJECTIVE
To provide detailed descriptions of the lumbar LF.


METHODS
Cadaveric dissection.


METHODS
The deep ligamentum flava of 14 formalin-fixed human cadaver lumbar spines (140 levels) were examined to assess their laminar attachments and lateral extents in relation to the intervertebral foramen.


RESULTS
The variable attachment of the deep layer of the LF with respect to the cephalad and caudad laminae was identified and described. At each successive caudal level of the lumbar spine, the deep layer appeared to become a more prominent feature of the posterior vertebral column, lining more of the laminae to which it is attached and encroaching further into the posteroinferior region of the intervertebral foramen at its lateral margins.


CONCLUSIONS
We describe our observations of the deep LF in the human lumbar spine. These observations have clinical relevance for the interpretation of radiologic imaging and the performance of adequate decompression in the setting of spinal stenosis.
Macquarie Neurosurgery, Australian School of Advanced Medicine, Macquarie University Hospital, Suite 201, Level 2, 2 Technology Place, Macquarie University, NSW 2109, Sydney, Australia; School of Medicine, University of New England, Armidale, NSW 2351, Australia. Electronic address: amtchau@gmail.com.
Anthony M T
AM
Chau
School of Medicine, University of New England, Armidale, NSW 2351, Australia.
Nicholas Robert
NR
Pelzer
School of Medicine, University of New England, Armidale, NSW 2351, Australia.
Jacob
J
Hampton
School of Medicine, University of New England, Armidale, NSW 2351, Australia.
Adam
A
Smith
Macquarie Neurosurgery, Australian School of Advanced Medicine, Macquarie University Hospital, Suite 201, Level 2, 2 Technology Place, Macquarie University, NSW 2109, Sydney, Australia.
Kevin A
KA
Seex
Macquarie Neurosurgery, Australian School of Advanced Medicine, Macquarie University Hospital, Suite 201, Level 2, 2 Technology Place, Macquarie University, NSW 2109, Sydney, Australia.
Fiona
F
Stewart
Macquarie Neurosurgery, Australian School of Advanced Medicine, Macquarie University Hospital, Suite 201, Level 2, 2 Technology Place, Macquarie University, NSW 2109, Sydney, Australia; School of Medicine, University of New England, Armidale, NSW 2351, Australia.
Cristian
C
Gragnaniello
D000368:Aged; D000369:Aged, 80 and over; D019299:Decompression, Surgical / Q000379:methods*; D005260:Female; D006801:Humans; D017843:Ligamentum Flavum / Q000033:anatomy & histology* / Q000601:surgery; D008159:Lumbar Vertebrae / Q000033:anatomy & histology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D013130:Spinal Stenosis / Q000601:surgery*
Anatomy; Intervertebral foramen; Lamina; Ligamentum flavum; Lumbar region; Spinal canal