title: Ligamentum flavum thickening at lumbar spine is associated with facet joint degeneration: An MRI study.
abstract: OBJECTIVE
  Degenerative changes in posterior elements of the spine such as thickening or hypertrophy of the ligamentum flavum (LF) may result in spinal stenosis. In the present study, we aimed to investigate the potential factors including age, intervertebral disc degeneration (IDD), facet joint degeneration (FJD), end plate degeneration (EPD), which may affect LF thickening and to reveal the relationship among those factors at each level of lumbar spine by evaluating the magnetic resonance images (MRI).
  
  
  METHODS
  A total of 200 individuals with low back and/or leg pain complaints who had undergone lumbar MRI were included in this study. The thickness of LF, FJD, IDD and EPD were assessed at all lumbar levels.
  
  
  RESULTS
  Totally 1000 end plates, 1000 intervertebral discs and 2000 facet joints were evaluated and the thicknesses of 2000 LFs were measured from MRI images of 200 patients (100 males and 100 females). The mean age was 46.87 ± 12.47 years. LF thickness was strongly associated with FJD especially on the ipsilateral side. Age and IDD were correlated at whole vertebral levels. The age related changes (LF thickness, FJD, IDD and EPD) were more prominent at L4-L5 vertebral level. However, gender had no effect on LF thickness.
  
  
  CONCLUSIONS
  The results of this study suggest that LF thickening may occur independently or could be associated with FJD especially on the ipsilateral side and this relationship is due to the vertebral level. The degree of disc degeneration increases with age and age related changes may be predominantly observed at L4-L5 vertebral level.
authors.affiliation: Department of Neurosurgery, Afyon Kocatepe University School of Medicine, Afyonkarahisar, Turkey.
authors.forename: Ergun
authors.initials: E
authors.lastname: Karavelioglu
authors.affiliation: Department of Radiology, Afyon Kocatepe University School of Medicine, Afyonkarahisar, Turkey.
authors.forename: Emre
authors.initials: E
authors.lastname: Kacar
authors.affiliation: Department of Anatomy, Afyon Kocatepe University School of Medicine, Afyonkarahisar, Turkey.
authors.forename: Yucel
authors.initials: Y
authors.lastname: Gonul
authors.affiliation: Department of Orthopaedics and Traumatology, Afyon Kocatepe University School of Medicine, Afyonkarahisar, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Eroglu
authors.affiliation: Department of Neurosurgery, Afyon Kocatepe University School of Medicine, Afyonkarahisar, Turkey.
authors.forename: Mehmet Gazi
authors.initials: MG
authors.lastname: Boyaci
authors.affiliation: Department of Physical Medicine and Rehabilitation, Afyon Kocatepe University School of Medicine, Afyonkarahisar, Turkey.
authors.forename: Selma
authors.initials: S
authors.lastname: Eroglu
authors.affiliation: Department of Radiology, Afyon Kocatepe University School of Medicine, Afyonkarahisar, Turkey.
authors.forename: Ebru
authors.initials: E
authors.lastname: Unlu
authors.affiliation: Department of Physical Medicine and Rehabilitation, Afyon Kocatepe University School of Medicine, Afyonkarahisar, Turkey.
authors.forename: Alper Murat
authors.initials: AM
authors.lastname: Ulasli
mesh_terms: D005260:Female; D006801:Humans; D055959:Intervertebral Disc Degeneration / Q000150:complications / Q000175:diagnosis*; D017843:Ligamentum Flavum / Q000000981:diagnostic imaging*; D008161:Lumbosacral Region; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D013130:Spinal Stenosis / Q000175:diagnosis / Q000209:etiology*; D021801:Zygapophyseal Joint / Q000000981:diagnostic imaging*
keywords: Ligamentum flavum; MRI; end plate degeneration; facet joint; intervertebral disc