In addition, the posterior midline ligaments, such as the supraspinous and interspinous ligaments
lose their original attachments when the spinous processes are removed.3-5 The reported disadvantages of extensive resection of the posterior bone, posterior ligaments and muscular structures include increase in post-operative pain, peri-operative blood loss, length of stay (LOS) at hospital, and adverse consequences of iatrogenic injury, like denervation atrophy of PVMs, lower back pain, segmental malalignment, instability and the so-called failed back surgery syndrome.2-6 Therefore, various minimally invasive techniques for spinal surgery have been developed to achieve comparable surgical outcomes with less surgical morbidity.
We made an incision of about 5 cm via the posterior approach with surgical gap as the center, and incised the skin and subcutaneous tissue successively, retaining supraspinal and interspinous ligaments
. Afterwards, we peeled off bilateral paravertebral muscles to expose bilateral vertebral plates and zygopophysis, conducted laminectomy and decompression for the affected side, removed ligamentum flavum exposed the endorhachis, nerve root, and pulled the dural sac and nerve root aside.
Elderly patients may have degenerative spinal diseases with narrowed interspinous and intervertebral spaces as a result of the ossification of the interspinous ligaments
and hypertrophy of the facet joints (44).
High signal intensity of the translation or interspinous ligaments
or along the rotation facet joints on T2 SPIR or STIR Table 3.
From the posterior approach, release consists of resection of spinous processes, interspinous ligaments
, facets, and intervertebral distraction.
Edema was also noted in the prevertebral and interspinous ligaments
spanning C1-C2 and C2-C3.
Similarly thoraco lumbar spine showed fibrosed interspinous ligaments
with limited intervertebral disc spaces.
Honsawek, "Isolation and characterization of human mesenchymal stem cells from facet joints and interspinous ligaments
," Spine, vol.
There was no evidence of cord oedema or injury to the interspinous ligaments
. Background cervical spondylosis and multi-level osteochondral bars are observed.
Ossification of the supraspinous and interspinous ligaments
produces a characteristic single or double radio-dense sign on the AP view of the spine (Fig.
It would appear that the solution is injected into the interspinous ligaments
of the low lumbar spine with the intention of inducing the production of fibrous issue and tightening up "mobile joints".
The interspinous ligaments
connect the spinous processes.