The cervical ligamentum flavum is the elastic posterior canal ligament between adjacent laminae, maintaining the posterior wall of the spinal canal. Its high elastin content (80%) returns the spine to neutral after flexion. Hypertrophy and calcification of the ligamentum flavum from degenerative disc disease is a major contributor to cervical canal stenosis and myelopathy.
| Origin | Inferior border of the upper lamina |
|---|---|
| Insertion | Superior border of the lower lamina — lines the posterior spinal canal between laminae |
| Actions | Restores the spine to neutral after flexion; provides the elastic posterior canal wall |
|---|
Ligamentum flavum hypertrophy visible on MRI as posterior T2-dark signal encroaching on the dural sac is a key finding in cervical stenosis assessment. Laminoplasty expands the canal by hinging the lamina open and recreating space behind the cord. The ligamentum flavum must be meticulously removed during decompression to avoid pushing calcified fragments into the cord.
Cervical ligamentum flavum thickening producing posterior cord compression managed with laminoplasty or laminectomy.
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