Department of Spine Surgery, Xi'an Jiaotong University Affiliated Honghui Hospital, Xi'an, China.
J Orthop Surg Res. 2024 Sep 6;19(1):548. doi: 10.1186/s13018-024-05047-6.
To analyze the characteristics of an unnamed interlaminar ligaments(ILL) through magnetic resonance image (MRI), endoscopy and pathological examination.
A retrospective study was conducted to analyze the clinical data of patients who underwent posterior endoscopic surgery for lumbar disc herniation or lumbar spinal stenosis from January 2021 to February 2022 at our medical center. The height, width and cross-sectional thickness of the ligament was analyzed using T2 weighted MRI. Meanwhile, the morphological and pathological characteristics were also compared with those of the ligamentum flavum to highlight the differences between above mentioned ligaments.
Forty-three patients were included in this study, including 27 males and 16 females, with an average age of 46.6 ± 12.1y. There were 20 cases of lumbar disc herniation and 23 cases of lumbar spinal stenosis. The width, length, thickness of the ILL, the thickness of LF and surgical time in the lumbar disc group were 17.7 ± 3.5 mm, 4.3 ± 1.3 mm, 18.3 ± 3.5 mm, 5.3 ± 1.9 mm, 53.2 ± 14.5 min, respectively. In the lumbar spinal stenosis group, the corresponding parameters were 16.0 ± 3.1 mm, 4.1 ± 1.6 mm, 17.6 ± 4.8 mm, 6.3 ± 0.8 mm, 61.8 ± 12.4 min, respectively. The intergroup difference in thickness of the ligamentum flavum was statistically significant (P = 0.02). The difference in surgical time was also established(P = 0.04). Endoscopic differences were identified as to the location of the anchor points and appearances among the two ligaments. Significant differences in the density and direction of fibrous structures were also observed under biopsy. Under endoscopy, significant difference as to the grade of ILL thickness was established when compared regarding disease spectrum (P = 0.09.) CONCLUSION: The interlaminar ligament is a structure that has not yet been officially named, which has significant structural differences from those of the ligamentum flavum. For posterior endoscopic procedure, its clinical significance lies in its ability to serve as the endpoint of soft tissue channel establishment. The thickness of the ligamentum flavum in MRI and the thickness of ILL under endoscopy vary according to the disease spectrum.
通过磁共振成像（MRI）、内窥镜和病理检查分析未命名的板间韧带（ILL）的特征。
对 2021 年 1 月至 2022 年 2 月在我院接受后路内窥镜手术治疗腰椎间盘突出症或腰椎管狭窄症的患者的临床资料进行回顾性研究。使用 T2 加权 MRI 分析韧带的高度、宽度和横截面积。同时，还比较了形态学和病理学特征，以突出两者之间的差异。
本研究共纳入 43 例患者，男 27 例，女 16 例，平均年龄 46.6±12.1 岁。其中腰椎间盘突出症 20 例，腰椎管狭窄症 23 例。腰椎间盘组的 ILL 宽度、长度、厚度、LF 厚度和手术时间分别为 17.7±3.5mm、4.3±1.3mm、18.3±3.5mm、5.3±1.9mm、53.2±14.5min；腰椎管狭窄组分别为 16.0±3.1mm、4.1±1.6mm、17.6±4.8mm、6.3±0.8mm、61.8±12.4min。两组 LF 厚度比较差异有统计学意义（P=0.02），手术时间比较差异亦有统计学意义（P=0.04）。内窥镜下可识别两种韧带的锚定点位置和外观不同。活检也观察到纤维结构的密度和方向存在显著差异。根据疾病谱，内窥镜下 ILL 厚度分级差异有统计学意义（P=0.09）。
板间韧带是一种尚未正式命名的结构，其与黄韧带的结构存在显著差异。对于后路内窥镜手术，其临床意义在于作为软组织通道建立的终点。MRI 中黄韧带的厚度和内窥镜下 ILL 的厚度随疾病谱而变化。
