Histology of the ligamentum flavum in patients with degenerative lumbar spinal stenosis |
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Authors: | P K Schräder Dieter Grob Berton A Rahn Jacques Cordey Jiri Dvorak |
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Institution: | (1) Department of Orthopaedics (RKU), University of Ulm, Oberer Eselsberg 45, D-89081 Ulm, Germany Tel.: +49-731-1770, Fax: +49-731-1771103, DE;(2) Spine Unit, Schulthess-Klinik, Zürich, Switzerland, CH;(3) AO-Research Institute Davos-Platz, Switzerland, CH |
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Abstract: | The degree of calcification as well as the structural changes of the elastic fibres in the ligamentum flavum in patients
with degenerative lumbar spinal stenosis were evaluated and the results were compared to those of patients without spinal
stenosis. In 21 patients (13 male, 8 female) with lumbar spinal stenosis the ligamentum flavum was removed, histologically
processed and stained. The calcification, the elastic/collagenous fibre ratio as well as the configuration of the fibres were
evaluated with an image analyzing computer. As a control group, 20 ligaments of 10 human corpses were processed in the same
way. The results were statistically analysed using the Mann-Whitney-Wilcoxon test (α = 0.05) and the t-test (α = 0.05). Nearly
all the ligaments of patients with lumbar spinal stenosis were calcified (average 0.17%, maximum 3.8%) and showed relevant
fibrosis with decreased elastic/collagenous fibre ratio. There was a significant correlation between age and histological
changes (P < 0.05). In the control group we only found minimal calcification in 3 of 20 segments (average 0.015%). No relevant fibrosis
was found and the configuration of elastic fibres showed no pathologic changes. The results of this study illustrate the important
role of histological changes of the ligamentum flavum for the aetiology of lumbar spinal stenosis.
Received: 31 July 1998 Revised: 19 March 1999 Accepted: 12 April 1999 |
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Keywords: | Lumbar spinal stenosis ligamentum flavum histology Lumbar spinal stenosis ligamentum flavum calcification Lumbar spinal stenosis ligamentum flavum elastic fibres |
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