Denticulate Ligaments

ligamentum denticulatum

The denticulate ligaments are two thin shelves of pia mater that run down each side of the spinal cord, midway between the dorsal and ventral nerve roots. Along their outer edges they form about 21 tooth-like points that attach through the arachnoid to the dura, holding the cord suspended in the middle of the dural sac.

Anatomical Data

Structure & Connections

Location	Each side of the spinal cord from the foramen magnum to around the conus medullaris, between the dorsal and ventral roots
Parts	Continuous medial pial attachment along the cord About 21 lateral tooth-like processes attached to the dura Lowest process near T12-L1
Connections	Pia mater of the spinal cord Spinal dura mater Spinal nerve roots (anterior and posterior to it)
Blood Supply	Pial branches of the spinal arteries

Biomechanics

Function & Actions

Anchor the spinal cord laterally within the dural sac, limiting its movement during spinal motion.

Clinical Relevance

Clinical Notes

The denticulate ligaments are an important surgical landmark: dividing them allows gentle rotation of the cord to reach anterior lesions. In cervical myelopathy, tethering by the denticulate ligaments may add tension to the cord during flexion. They help separate the dorsal and ventral roots on imaging and in surgery.

Pathology

Common Injuries & Conditions

Cervical Spondylotic Myelopathy (Tethering Component)

Cord damage from degenerative narrowing of the cervical canal, possibly worsened by tension transmitted through the denticulate ligaments in flexion.

Spinal Cord Herniation

Rare protrusion of the thoracic cord through a defect in the anterior dura, which normal denticulate ligament anchoring usually prevents.

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