The superior band of the iliolumbar ligament runs from the tip and anterior aspect of the L5 transverse process to the anterior iliac crest, providing the superior restraint of the L5 vertebra.
Limits lateral bending of L5 on the ilium, resists superior migration of the iliac crest, and stabilises the lumbosacral junction from lateral displacement forces.
The superior iliolumbar band is assessed in cases of iliolumbar ligament syndrome — localised pain at the PSIS reproduced by lateral bending away from the affected side. This syndrome is often misdiagnosed as SIJ dysfunction. Targeted injection of the superior band under fluoroscopic guidance is both diagnostic and therapeutic.
Pain at the PSIS from superior iliolumbar band strain reproduced by contralateral side bending, treated by targeted injection and core stability rehabilitation.
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