Afterwards, it reaches the superior margin of the scapula, and finally it passes over the superior transverse scapular ligament (STSL) to enter the supraspinous
However, the needle will traverse additional layers comprised of the supraspinous
and interspinous ligaments, which might be calcified especially in elderly patients.
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.
In elderly patients it is difficult to do lumbar puncture due to ossification of supraspinous
and interspinous ligaments14,11.
Diagnosis of back pain is not simple; contributing factors may include needle trauma, surgical positioning and injection of saline or local anaesthetic into the interspinous ligaments, development of a supraspinous
haematoma, excessive stretching of ligaments after relaxation of paraspinal muscles and localised trauma to the intervertebral disc.
The ligaments are anterior longitudinal (ALL), posterior longitudinal (PLL), ligamentumflavum (LF), interspinous (ISL), supraspinous
(SSL), intertransverse (ITL), and Facet capsulary (FCL).
Yet none of these Middenbeemster individuals possess lesions considered highly diagnostic for scurvy (i.e., porosity of the sphenoid greater wing, posterior maxilla, and scapular supraspinous
and infraspinous fossae; see Klaus 2017; Schattmann et al.
It is held in position by three mesh bands, two around each spinous process and one around the supraspinous
Caption: Figure 2: The anatomic sites for pressure pain threshold evaluations over the muscles, patellar tendon, pes anserinus bursae, and supraspinous
ligaments in the anterior, posterior, and lateral views.
fossa of the scapula is resected, while being cautious not to injure the suprascapular neurovasculature, and the latissimus dorsi and serratus anterior are detached from the scapula as well.
The TLICS incorporates the integrity of the PLC, including the supraspinous
and interspinous ligaments, the ligamentum favum, and the facet joint capsules, in determination of spinal stability.
The subcapular, abdominal, axillary, suprailiac, and supraspinous
cutaneous folds (DC) were measured in a circuit with an adipometer (Lange, US Chemical, USA), with a 1 mm scale and constant pressure (8.9 g*[mm.sup.-2]) in all bar opening angles.