The supraspinous ligament connects the spinous process tips of the thoracic spine in a continuous band, forming the posterior tension band resisting flexion. In the cervical spine it becomes the ligamentum nuchae. Supraspinous ligament tears from hyperflexion injuries indicate posterior column disruption in thoracic fracture classification.
| Origin | Spinous process tips T1-T12 |
|---|---|
| Insertion | Continuous superficial ligament connecting spinous process tips |
| Actions | Resists thoracic flexion (most thoracic flexion occurs at the intervertebral discs — the supraspinous ligament is the most posterior restraint) |
|---|
Interspinous-supraspinous ligament complex disruption produces the midline tenderness and spinous process gap (interspinous widening) that indicates a potentially unstable flexion-distraction or flexion injury of the thoracic spine. MRI confirms posterior ligamentous complex integrity, which determines operative versus non-operative management of thoracolumbar fractures.
Supraspinous and interspinous ligament tearing in thoracolumbar flexion-distraction injury indicating instability managed with posterior instrumented fusion.
