The interspinous ligaments fill the space between adjacent spinous processes, working with the supraspinous ligament and ligamentum flavum to form the posterior ligamentous complex (PLC). PLC integrity is a key determinant of spinal stability in trauma classification systems — intact PLC suggests stable injury, disrupted PLC indicates instability. MRI reliably assesses PLC integrity through signal changes in the supraspinous and interspinous ligaments.
| Origin | Inferior border of the spinous process above |
|---|---|
| Insertion | Superior border of the spinous process below — at each level |
| Actions | Connects adjacent spinous processes; limits flexion and spinous process separation |
|---|
The thoracolumbar injury classification and severity score (TLICS) incorporates PLC status (intact, suspected disrupted, or disrupted) as a major determinant of surgical versus non-operative management. Disrupted PLC from flexion-distraction injuries requires posterior tension band reconstruction.
Interspinous and supraspinous ligament disruption in thoracolumbar fractures adding to TLICS score and favouring surgical management.
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