Thickening of spine ligamentum flavum and facet
               tropism

Appolonio, Paulo Roberto; Mattar, Thiago; Costa, Alexandre Barros; Valesin Filho, Edgar Santiago; Rodrigues, Luciano Miller Reis

doi:10.1590/S1808-18512014130100350

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Original Articles • Coluna/Columna 13 (01) • 2014 • https://doi.org/10.1590/S1808-18512014130100350 copy

Thickening of spine ligamentum flavum and facet tropism

Espessamento do ligamento amarelo da coluna vertebral e tropismo facetário

Engrosamiento del ligamento amarillo de la columna vertebral y tropismo facetario

SCIMAGO INSTITUTIONS RANKINGS

OBJECTIVE:

This study investigated the thickening of the ligamentum flavum (LF) and its correlation with facet tropism and its severity at different levels of the spine.

METHOD:

This retrospective study was performed with patients with chronic back pain consecutively admitted to a specialized spinal surgery service between January 2012 and January 2013. All patients underwent magnetic resonance imaging (MRI) to measure the thickness of the LF and facet tropism severity (severe, moderate or absent) according to the spine levels (L3 -L4, L4-L5, L5-S1). The association between the thickness of LF and facet tropism was analyzed.

RESULTS:

During the study period, 98 consecutive patients were enrolled with a mean age of 53.6 years, most women (59.2%). There was no significant difference between the thicknesses of the ligament and the presence of tropism in different spinal levels (p > 0.05). The thickness of LF was significantly associated with the severity of tropism only in L5-S1 level (p < 0.03).

CONCLUSIONS:

Our results show that there is a positive relationship between severe facet tropism and increased thickness of the LF in the L5-S1 level.

Spine; Ligamentum flavum; Intervertebral disc; Intervertebral disc degeneration

Variable	Mean (SD)
Thickness L3/L4	0.262 (0.081)
Thickness L4/L5	0.345 (0.104)
Thickness L5/S1	0.273 (0.079)
Tropism L3/L4	N (%)
Absent	56 (57.2)
Moderate	31 (31.6)
Severe	11 (11.2)
Tropism L4/L5
Absent	50 (51.0)
Moderate	36 (36.7)
Severe	12 (12.3)
Tropism L5/S1
Absent	45 (45.9)
Moderate	38 (38.8)
Severe	15 (15.3)

Variable	Tropism	Mean	SD	Median	Minimum	Maximum	N	p
Thickness L3/L4	Absent	0.262	0.078	0.28	0.11	0.54	56	0.929
Thickness L3/L4	Present	0.263	0.085	0.26	0.12	0.44	42	0.929
Thickness L4/L5	Absent	0.340	0.103	0.33	0.18	0.58	50	0.575
Thickness L4/L5	Present	0.351	0.106	0.36	0.17	0.57	48	0.575
Thickness L5/S1	Absent	0.262	0.072	0.26	0.14	0.44	45	0.185
Thickness L5/S1	Present	0.283	0.085	0.28	0.14	0.54	53	0.185

Variable	Tropism	Mean	SD	Median	Minimum	Maximum	N	p
Thickness L3/L4	Absent	0.262	0.078	0.28	0.11	0.54	56	0.84
	Moderate	0.267	0.089	0.26	0.12	0.44	31
	Severe	0.251	0.078	0.23	0.16	0.42	11
Thickness L4/L5	Absent	0.340	0.103	0.33	0.18	0.58	50	0.82
	Moderate	0.349	0.102	0.32	0.17	0.56	36
	Severe	0.359	0.122	0.39	0.17	0.57	12
Thickness L5/S1	Absent	0.262	0.072	0.26	0.14	0.44	45	0.01
	Moderate	0.265	0.082	0.25	0.14	0.44	38
	Severe	0.329	0.077	0.33	0.23	0.54	15

Comparison	Mean difference	Standard error	p	CI (95%)
Comparison	Mean difference	Standard error	p	Inferior	Superior
Absent-Moderate	-0.003	0.017	> 0.999	-0.044	0.038
Absent-Severe	-0.067	0.023	0.012	-0.123	-0.011
Moderate-Severe	-0.064	0.023	0.023	-0.121	-0.007

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E-mail: coluna.columna@uol.com.br

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[1] Correspondence: Luciano Miller Reis Rodrigues. Rua Tucumã, 199, apto 141. São Paulo. SP, Brasil. 01455-010. luciano.miller@uol.com.br