open access

Vol 77, No 4 (2018)
ORIGINAL ARTICLES
Published online: 2018-03-12
Submitted: 2018-01-01
Accepted: 2018-02-26
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The posterior epidural ligament in the thoracic region: a cadaveric and histological study

C. T. Rimmer, P. J. Adds
DOI: 10.5603/FM.a2018.0024
·
Pubmed: 29569699
·
Folia Morphol 2018;77(4):748-751.

open access

Vol 77, No 4 (2018)
ORIGINAL ARTICLES
Published online: 2018-03-12
Submitted: 2018-01-01
Accepted: 2018-02-26

Abstract

The existence of posterior epidural ligaments (PEL) has been established in the lumbar region, but they have hitherto not been shown to exist in the thoracic vertebral column. Their identification is of clinical significance in respect to incidental durotomy and the circulation of cerebrospinal fluid (CSF). Fourteen thoracic spine sections were dissected by cutting through the intervertebral disc and separating the ligamentum flavum from the vertebra above. The dural sheath was gently retracted anteriorly to identify macroscopic connections between the ligamentum flavum and the dura. Macroscopic connections observed were dissected out, retaining some dural sheath and ligamentum flavum. Histological
staining with haematoxylin and eosin and Miller’s elastin stain was used to investigate cellular connections. Thoracic PELs were positively identified in 5 of the 14 cadavers (35.7%). Histology showed similarities between the thoracic and lumbar
PELs. Fifteen separate PELs were identified within these five thoracic sections. The thoracic PEL has sufficient tensile strength to present a risk to the integrity of the dural sheath during surgery, and surgeons should be aware of these connections when operating on the thoracic spine. PELs may also contribute to the circulation of CSF in the spinal subarachnoid space.

Abstract

The existence of posterior epidural ligaments (PEL) has been established in the lumbar region, but they have hitherto not been shown to exist in the thoracic vertebral column. Their identification is of clinical significance in respect to incidental durotomy and the circulation of cerebrospinal fluid (CSF). Fourteen thoracic spine sections were dissected by cutting through the intervertebral disc and separating the ligamentum flavum from the vertebra above. The dural sheath was gently retracted anteriorly to identify macroscopic connections between the ligamentum flavum and the dura. Macroscopic connections observed were dissected out, retaining some dural sheath and ligamentum flavum. Histological
staining with haematoxylin and eosin and Miller’s elastin stain was used to investigate cellular connections. Thoracic PELs were positively identified in 5 of the 14 cadavers (35.7%). Histology showed similarities between the thoracic and lumbar
PELs. Fifteen separate PELs were identified within these five thoracic sections. The thoracic PEL has sufficient tensile strength to present a risk to the integrity of the dural sheath during surgery, and surgeons should be aware of these connections when operating on the thoracic spine. PELs may also contribute to the circulation of CSF in the spinal subarachnoid space.

Get Citation

Keywords

thoracic spine, dura, ligamentum flavum, incidental durotomy, cerebrospinal fluid

About this article
Title

The posterior epidural ligament in the thoracic region: a cadaveric and histological study

Journal

Folia Morphologica

Issue

Vol 77, No 4 (2018)

Pages

748-751

Published online

2018-03-12

DOI

10.5603/FM.a2018.0024

Pubmed

29569699

Bibliographic record

Folia Morphol 2018;77(4):748-751.

Keywords

thoracic spine
dura
ligamentum flavum
incidental durotomy
cerebrospinal fluid

Authors

C. T. Rimmer
P. J. Adds

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