Is there a relationship between low back pain and ligamentum flavum hypertrophy?

A.H. Ali, O. Serhan, H. Ali Amer, H. Salem Aldosari, A. Alodaib, T. Hazaazi, A. Albogami, A. Alyamni, S. Alkanaan, A. Albassam, O. Alalwi, A.A. Alghamdi, A.K. Alhuthayli, A.M. Amany, H.A. Aboelsoud

Anatomy Department, College of Medicine, Prince Sattam Bin Abdulaziz University, Al-Kharj, KSA. alihassan3750@yahoo.com

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• Orthopedics

OBJECTIVE: A condition known as ligamentum flavum (LF) hypertrophy occurs when the ligamentum flavum (LF) swells as a result of pressures applied to the spine. Among the elderly population, lumbar spinal stenosis is a major cause of pain and disabilities. Numerous studies indicate that lumbar spinal stenosis etiology involves the ligamentum flavum in a major way. This study looks into the relationship between low back pain and ligamentum flavum thickening.

PATIENTS AND METHODS: The imaging tests and case histories of all patients with low back pain who had consecutive magnetic resonance imaging exams performed at the Prince Sattam University and King Khalid hospitals in Al Kharj City will serve as the basis for this retrospective observational study. A radiologist utilized the Pfirrmann grading system, which is based on spinal levels starting from the first lumbar to the first sacral vertebrae, to measure the thickness of the ligamentum flavum in all cases who underwent magnetic resonance imaging (MRI). A correlation between age, hypertrophy of LF, and low back pain was investigated.

RESULTS: There were 79 participants in the study, ages ranging from 21 to 82, 49 of which were men. The patients’ average age was 54 years, and 62% of them were men. We found no appreciable variations in LF thickness according to gender. At the L4-L5 and L5-S1 levels, the left LF was noticeably thicker than the right. Moreover, there was a significant difference (p < 0.05) in the bilateral LF thicknesses at L5-S1 compared to the comparable sides at L4-L5.

CONCLUSIONS: By evaluating the thickness of LF on magnetic resonance images, we discovered that it may be closely associated with the etiology of pain processes in the spine.

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