Affiliations: [a] Department of Neurosurgery, Afyon Kocatepe University School of Medicine, Afyonkarahisar, Turkey | [b] Department of Radiology, Afyon Kocatepe University School of Medicine, Afyonkarahisar, Turkey | [c] Department of Anatomy, Afyon Kocatepe University School of Medicine, Afyonkarahisar, Turkey | [d] Department of Orthopaedics and Traumatology, Afyon Kocatepe University School of Medicine, Afyonkarahisar, Turkey | [e] Department of Physical Medicine and Rehabilitation, Afyon Kocatepe University School of Medicine, Afyonkarahisar, Turkey
Correspondence:
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Corresponding author: Yucel Gonul, Department of Anatomy, School of Medicine, Afyon Kocatepe University, 03200 Afyonkarahisar, Turkey. Tel.: +90 505 5715259; Fax: +90 272 246 3300; E-mail:yucel94@hotmail.com
Abstract: OBJECTIVE: Degenerative changes in posterior elements of the spine such as thickening
or hypertrophy of the ligamentum flavum (LF) may result in spinal stenosis.
In the present study, we aimed to investigate the potential factors
including age, intervertebral disc degeneration (IDD), facet joint
degeneration (FJD), end plate degeneration (EPD), which may affect LF
thickening and to reveal the relationship among those factors at each level
of lumbar spine by evaluating the magnetic resonance images (MRI). METHODS: A total of 200 individuals with low back and/or leg pain complaints
who had undergone lumbar MRI were included in this study. The thickness of LF, FJD,
IDD and EPD were assessed at all lumbar levels. RESULTS: Totally 1000 end plates, 1000 intervertebral discs and 2000 facet joints
were evaluated and the thicknesses of 2000 LFs were measured from MRI images
of 200 patients (100 males and 100 females). The mean age was 46.87 ±
12.47 years. LF thickness was strongly associated with FJD especially on the ipsilateral
side. Age and IDD were correlated at whole vertebral levels. The
age related changes (LF thickness, FJD, IDD and EPD) were more prominent at
L4-L5 vertebral level. However, gender had no effect on LF thickness. CONCLUSION: The results of this study suggest that LF thickening may occur
independently or could be associated with FJD especially on the ipsilateral side and this
relationship is due to the vertebral level. The degree of disc degeneration
increases with age and age related changes may be predominantly observed at
L4-L5 vertebral level.
