Role of Ligamentum Flavum Hypertrophy in Low Back Pain

Abstract

Background: Lumbar canal stenosis is a significant cause of pain and disability. Compression of the neural elements occurs with changes in the local anatomy. The degenerative changes include disc deterioration and facet joint arthrosis and ligamentum flavum hypertrophy. Even though many studies have shown the significance of ligamentum flavum hypertrophy in patients with spinal canal stenosis, very few studies have examined ligamentum flavum thickness and its relation age and lumbar level.Methods: Study was conducted at Kanyakumari government medical college for a period of 12 months from November 2021 to November 2022. Total of 50 patients were included in the study presenting with complaints of lower back pain, radiculopathy and neurogenic claudication.Results: Using MR imaging we measured ligamentum flavum of a total 50 patients. Thickness of ligamentum flavum was increased – older patients, lower lumbar level and symptomatic. Lateral recess stenosis, which is a frequent finding with patients with lumbar radiculopathy – close proximity of ligamentum flavum with facet joint where motion and degenerative changes are more appreciated.Conclusions: Our study confirmed increase in ligamentum flavum thickness as age increased and lumbar level in symptomatic patients. This finding may represent the degenerative process in the ligamentum flavum that occurs with age and also supports the reactive nature of the ligamentum flavum to increased mechanical forces at lower lumbar level.