Anatomic study and clinical significance of the dorsal meningovertebral ligaments in lumbosacral region

English Keywords:Lumbosacral region  Meningovertebral ligaments  Dura laceration

English Abstract:

  【Abstract】　Objective：To determine the morphology and morphometry of the dorsal meningovertebral ligaments in lumbosacral region.Method：The dorsal meningovertebral ligaments in lumbosacral region wｅｒｅ observed endoscopicly on 30 adult embalmed cadavers（aged 40-70 yearｓ，mean 52 yearｓ），and then the spinal canal was opened，the morphology，orientation，attachment sites and distribution of the ligaments wｅｒｅ observed by naked eye and surgical microscope.Finally，the length，width or diameter and thickness of the ligaments under the surgical microscope wｅｒｅ measured using vernier caliper.Result：The dorsal meningovertebral ligaments in lumbosacral region connected the dura ｗｉｔｈ yellow ligament as well as lamina.The attachment points of yellow ligament were relatively ｍｏｒｅ，with the maximum frequency of 97% at L5/S1.The ligaments reached their greatest thickness at L5/S1-S2.Ligaments′lengthｓ varied from 6.02mm to 40.24mm and the orientationｓ of the ligaments wｅｒｅ from superoanterio to inferoposterior（dura to yellow ligament or lamina）.Ｔｈｅ　ｓｈａｐｅｓ　ｏｆ　ｌｉｇａｍｅｎｔｓ　ｗｅｒｅ divided into five types：strip-type，cord-type，Y-shaped type，grid type and thin slice type.Conclusion：The ligaments connecting the dura and yellow ligament as well as lamina exist in dorsal lumbosacral epidural space.Inadvertent management of these ligaments ｈａｓ potential risk for inducing dural lacerations and epidural hemorrahage.Dissecting the meningovertebral ligaments before the discectomy may reduce postoperative cerebrospinal fluid leakage.