• Yutaka Yabe, Yoshihiro Hagiwara, Masahiro Tsuchiya, Yoshito Onoda, Shinichirou Yoshida, Takahiro Onoki, Keisuke Ishikawa, Daisuke Kurosawa, and Eiichi Murakami.
• Department of Orthopaedic Surgery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.
• Spine. 2022 Jul 15; 47 (14): 103610411036-1041.

Study DesignExperimental study of the ligamentum flavum (LF) thickness among patients with lumbar spinal canal stenosis (LSCS).ObjectivesTo elucidate the factors associated with thickening of the LF on magnetic resonance imaging (MRI).Summary Of Background DataThickening of the LF is a major contributor to LSCS. This thickening is attributed to tissue hypertrophy or buckling of the ligament, and there may be several associated factors on MRI; however, these factors remain unclear.MethodsWe studied the LF in 56 patients (a total of 106 ligaments) with LSCS, who underwent decompressive surgery; among them, 23 were receiving haemodialysis. The Pearson correlation coefficient was used to assess relationships between the thickness of the LF on MRI and the thickness of the LF tissue, age, disc height, disc degeneration, and disc level. Patients were also categorised into 2 groups based on whether they were undergoing haemodialysis, and the relationships were assessed similarly.ResultsAmong patients with LSCS, the thickness of the LF on MRI showed a significant positive linear relationship with the thickness of the LF tissue, and no association with disc height. Except for in those receiving haemodialysis, the thickness of the LF on MRI showed a significant positive relationship with age, disc degeneration, and disc level among patients with LSCS.ConclusionIn patients with LSCS, thickening of the LF on MRI appears to represent tissue hypertrophy. The association between the thickness of the LF on MRI and age, disc degeneration, and disc level may indicate simultaneous alterations of spine components along with aging that was cancelled by the effects of haemodialysis.Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.

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