The inferior band of the iliolumbar ligament runs from the anterior inferior transverse process of L5 to the posterior ilium and upper anterior sacrum, blending with the anterior sacroiliac ligament.
Resists anterior translation of L5 on the sacrum, limits L5 rotation, and provides the primary constraint against L5 isthmic spondylolisthesis progression in high-grade slips.
The inferior iliolumbar band is at risk during L5-S1 interbody fusion approaches — its division during lateral access to L5-S1 contributes to post-operative L5-S1 instability until fusion consolidates. In high-grade L5-S1 spondylolisthesis reduction, this band must be released for adequate reduction.
Release of the inferior iliolumbar band during high-grade spondylolisthesis reduction surgery to allow L5 to be translated posteriorly to a more normal position.
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