Contemporary views on the ossification of the ligamenta flava

Abstract

Wię za dła żół te są struk tu ra mi, któ re wraz z blasz ka mi łu ków krę go wych, bu du ją tyl ną ścia nę ka na łu krę gowe go. Bez po śred nie są siedz two z struk tu ra mi ner wo wy mi rdze nia krę go we go po wo du je, że ka żda pa to lo gia pro wa dzą ca do ich prze ro stu pro wa dzi w kon se kwen cji do za bu rzeń neu ro lo gicz nych. Jed ną z naj częst szych przy czyn ta kie go prze ro stu jest he te ro to po we kost nie nie. Głów ny mi re jo na mi świa ta do tknię ty mi tym scho rzeniem są kra je Azji, zwłasz cza Ja po nia. Zda rza ją się jed nak co raz częst sze przy pad ki wy stę po wa nia skost nień wię za deł żół tych wśród in nych po pu la cji. Za naj wa żniej szą przy czy nę two rze nia się ek to pi czej tkan ki kost nej w ob rę bie tych wię za deł uwa ża się stres me cha nicz ny o cha rak te rze ro ta cyj nym i roz cią go wym, a ta kże uwarun ko wa nia ge ne tycz ne. Le cze nie tej pa to lo gii ogra ni cza się głów nie do pro ce dur ope ra cyj nych. Ni niej szy arty kuł jest prze glą dem współ cze snej wie dzy na te mat przy czyn he te ro to po we go kost nie nia wię za deł żół tych, skut ków wy wo ły wa nych przez to scho rze nie oraz spo so bów ich le cze nia. Sło wa klu czo we: wię za dła żół te, kost nie nie he te ro to po we, ka nał krę go wy, krę go słup SUMMARY The ligamenta flava, together with the vertebral lamina, form the posterior wall of the spinal canal. Since they are located immediately adjacent to the nerve structures of the spinal cord, every pathology that involves hypertrophy produces neurological disturbances as a result. One of the most common reasons for hypertrophy of the ligamenta flava is heterotopic ossification. The main regions of the world where this disorder occurs are the Asian countries, especially Japan, but there are increasing numbers of such cases in other populations. The most important causes of the formation of ectopic osseous tissue in the vicinity of the ligamenta flava are thought to be mechanical stress and genetic predisposition. Treatment is mostly limited to surgical procedures. The present study is a review of the current state of our knowledge concerning the ossification of the ligamenta flava, the sequelae of this pathology, and the treatment methods.

The Impact of Spine Pathology on Posterior Ligamentous Complex Structure and Function

“…Ligament hypertrophy is a common cause of spinal stenosis especially in the LF and can result in neural impingement and pain [72]. This process is thought to be driven by the ossification of the ligament in cases of high mechanical or other stressors [72].…”

“…Ligament hypertrophy is a common cause of spinal stenosis especially in the LF and can result in neural impingement and pain [72]. This process is thought to be driven by the ossification of the ligament in cases of high mechanical or other stressors [72]. Hypertrophic ossification of the LF involves replacement of fibroblasts with chondrocytes, necrosis, and alterations in collagen-proteoglycan content and structure [72].…”

“…This process is thought to be driven by the ossification of the ligament in cases of high mechanical or other stressors [72]. Hypertrophic ossification of the LF involves replacement of fibroblasts with chondrocytes, necrosis, and alterations in collagen-proteoglycan content and structure [72]. The overall pathophysiology of these changes in LF is well studied as LF hypertrophy is a common condition which may result in functional and neurologic deficits [72].…”

Cyclic stretch promotes the ossification of ligamentum flavum by modulating the Indian hedgehog signaling pathway

“…Moreover, OLF is closely related to disturbance of the local mechanical microenvironment of the spine (12). The reduced stability of the middle and lower thoracic joints (T) due to long-term rotational motions has been indicated the anatomical basis of OLF (13). A previous study reported T9-T12 are the common segments affected by OLF, suggesting that increases in local stress caused by longitudinal axial instability of the middle and lower thoracic spine may be the biomechanical basis of OLF (14).…”

Model of Pathological Collagen Mineralization Based on Spine Ligament Calcification

“…A significant role in pathological tissue calcification is attributed to mechanical stress (accumulation of microtrauma). The experimental studies performed on the spines of rats demonstrated that stretching and torsion movements result in the proliferation of cartilage tissue, transforming into bone tissue in the spinal ligaments [11,12]. Similarly, studies performed on patients exposed to stretching showed an increase in the rate of cytokines associated with the bone formation process (i.e., bone morphogenic protein, BMP) [11,12].…”