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Low Back Pain
Published in Benjamin Apichai, Chinese Medicine for Lower Body Pain, 2021
The supraspinous ligament is the part of the interspinous ligament that moves backward.29 The supraspinous ligament is a long, thick, and strong fibrous cord that connects together the tips of the spinous processes spanning from the seventh cervical vertebra to the 3rd or 4th lumbar vertebrae.
A to Z Entries
Published in Clare E. Milner, Functional Anatomy for Sport and Exercise, 2019
The anterior longitudinal ligament is wide and strong. It runs along the anterior side of the vertebral bodies and attaches to both the vertebrae and intervertebral discs. It helps to prevent hyperextension of the back. The posterior longitudinal is narrower and weaker than the anterior ligament. It runs along the posterior side of the vertebral bodies, inside the vertebral canal (see vertebral structure). This ligament attaches only to the intervertebral discs and its role is to help prevent hyperflexion of the spine. The ligamentum flava are a series of ligaments which join the laminae of adjacent vertebral arches together, making up the posterior wall of the vertebral canal. They derive their name from its unusual yellow colour (‘flavum’ in Latin), which is due to their high elastin content. Ligaments are usually inextensible cords, but the ligamentum flavum is more like an elastic band. It stretches when the trunk flexes, which helps to prevent rapid flexion that might result in injury to the intervertebral discs. It then recoils as the trunk extends and assists with this movement. The interspinous ligaments link the bodies of adjacent spinous processes throughout the vertebral column, and are relatively weak. The supraspinous ligament connects the tips of the spinous processes and is much stronger, helping to prevent hyperflexion of the back. Additional, smaller ligaments include the intertransverse ligaments, which link adjacent transverse processes. These are stronger in the thoracic region than elsewhere in the vertebral column.
The Governor Vessel (GV)
Published in Narda G. Robinson, Interactive Medical Acupuncture Anatomy, 2016
Supraspinous ligament: Connects the apices of the spinous processes of adjacent vertebrae. The ligamentum nuchae embodies the cephalad extension of the supraspinous ligament, acting as an important stabilizer of the cervical spine. Caudal to L4, the supraspinous ligament exhibits less organization and dissolves into the thoracolumbar fascia.1 In the lumbar spine of the human, the connective tissue of the supraspinous ligament arises from the midline attachments of the dorsal layer of the thoracolumbar fascia as well as the longissimus and multifidus muscles. Dense connective tissue fibers from the thoracolumbar fascia form distinctive bands that cross the midline and then merge with fibers from the other side to form the supraspinous and interspinous ligaments. In the upper thoracic spine, a different set of muscles contributes to midline ligament formation. That is, the trapezius, rhomboideus major, and splenius cervicis meld with deep fascia and in the midline produce the supraspinous ligament.9
Finite element analysis of lumbar spine with different backpack positions in parachuting landing
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2021
Chenyu Luo, Tianyun Jiang, Shan Tian, Yubo Fan
With the flexion of trunk, the posterior ligaments including ligamentum flavum, interspinours ligament, intermuscular transverse ligament and supraspinous ligament were tensed. The increase in the leaning angle also indicated the increase of ligaments stresses (Sharma et al. 1995; Wang et al. 2017). In each intervertebral disc, posterior fibers were tensed, while the anterior fibers were not (Figure 4). This is consistent with the study that fibers were stressed to support the intervertebral discs stability (Wang et al. 2017). On the other hand, the anterior matrix and nucleus were compressed. Based on the results in Table 2, matrix and nucleus injuries would most possibly occur at the intervertebral disc L4–L5 due to the high Von-Mises stress. It was reported that under axial compression load, the intradiscal pressure of L1–L2 was close to L4–L5 (Rohlmann et al. 2005; Kuo et al. 2010). In this study, the intradiscal pressure occurred at L4–L5, which might due to the leaning forward flexion.
Efficacy of interspinous device on adjacent segment degeneration after single level posterior lumbar interbody fusion: a minimum 2-year follow-up
Published in British Journal of Neurosurgery, 2021
Kwang Ryeol Kim, Chang Kyu Lee, In Soo Kim
All patients underwent L4/5 PLIF. Fourteen patients received concomitant DIAM implantation on L3/4 (Group A) while 37 underwent only L4/5 PLIF (Group B). PLIF procedures included laminectomy, medial facetectomy, excision of ligamentum flavum and discectomy followed by interbody fusion by autograft for 41 patients and PEEK cage for 10 patients with iliac bone graft and rigid pedicle screw fixation. In Group A, the DIAM implant was placed between spinous processes after the interspinous ligament was removed at the adjacent rostral level. The supraspinous ligament was preserved. If the ligamentum flavum was hypertrophied, it was removed to prevent compression of the thecal sac. It was unnecessary to extend skin incisions in Group A. The implant size was determined by inserting template trials (8, 10, 12 and 14 mm). The implant was firmly anchored in place using two tethers passing around two adjacent spinous processes. These tethers were secured to the implant by crimps (Figure 1).
A comparison of the efficacy of nonweight-bearing and weight-bearing exercise programmes on function and pain pressure thresholds in knee osteoarthritis: a randomised study
Published in European Journal of Physiotherapy, 2021
Vanessa Martins Pereira Silva Moreira, Fabiana da Silva Soares, Wallisen Tadashi Hattori, Valdeci Carlos Dionisio
To evaluate PPTs (Figure 1), a digital force gauge (Force TEN™; FDX Wagner Instruments, Greenwich, United States of America) was used with a flat head 1-inch in diameter and a pain metre for detection and quantification of mechanical hyperalgesia [12]. PPTs at dermatomes were measured in lumbar and sacral segments (L1, L2, L3, L4, L5, S1, and S2). PPTs at myotomes were measured in nine predetermined sites (vastus medialis, vastus lateralis, adductor longus, rectus femoris, tibialis anterior, peroneus longus, iliacus, quadrates lumborum, and popliteous muscles). In addition, PPTs at the sclerotomes of supraspinous ligaments at lumbar and sacral levels (L1–L2, L2–L3, L3–L4, L4–L5, L5–S1, and S1–S2) were evaluated, as well as sclerotomes in pes anserinus bursae and patellar tendon. These dermatomes, myotomes, and sclerotomes are based on the methodology used by Imamura et al. [12] and were chosen because they originate in the same nerve roots of the spinal cord. Thus, the assessment covered both superficial nerve endings (dermatomes) and deep nerve endings (sclerotomes and myotomes) of the same part of the spinal nerves [12]. The digital force gauge was pressed on each of these sites until the pressure became painful for the person. PPTs were measured in the most affected lower limb and expressed in kgf/cm2, with the highest values indicating less severe symptoms.