The Interspinous Ligament Of The Lumbar Spine:A Cross-sectional Frequency-matched Case-control Study

Study Design. A cross-sectional frequency-matched case-control study in the interspinous ligament (ISL) of the lumbar spine.Objective. To investigate the imaging assessment of the ISL degeneration in patients with or without low back pain (LBP).Summary of Background Data. The ISL degeneration is one of the underlying etiologies of LBP. Although it may be observed in asymptomatic population, little information is available in the literature.Methods. In this study,120 patients with or without LBP were enrolled in Group 1 and 2, respectively. Subjects in Group 2 were frequency-matched by age and sex with patients in Group 1. Two parameters on magnetic resonance imaging (ISL and intervertebral disc) were graded according to degeneration at four lumbar spinal levels. Results. Type A ISL was the most prevalent type in both groups, and Type D was the less one. There was a significant difference of Type D in Group 1 and Group 2 (5.4% vs.1.3%, p<0.05). The average age of Type D in Group 1 was greater than other types (p< 0.01 vs. Type A and B, and p<0.05 vs. Type C). In Group 2, there was a significant increase in age when compared Type D and Type A (p< 0.05). Although there tended to be increased disc grade in advanced ISL in both groups, there was only a statistical significance between Type D and Types A and B in Group 1 (p<0.05).Conclusions. The tendency of the ISL degeneration in asymptomatic population was similar as that in symptomatic population, with the more advanced ISL grade, the less commonly observed. The advanced change of the ISL was more common in patients with LBP. It seemed that the ISL degeneration occurred in more severe disc degeneration.