The thoracic interspinous ligaments are intermediate in thickness between the thin cervical and robust lumbar versions. They resist the flexion that is the primary injury mechanism of the thoracic spine. In thoracolumbar fracture classification (AO and TLICS systems), the interspinous-supraspinous complex integrity determines posterior ligamentous complex (PLC) status — a key factor in operative versus non-operative decision making.
| Origin | Inferior border of each thoracic spinous process |
|---|---|
| Insertion | Superior border of the adjacent lower spinous process |
| Actions | Resists thoracic flexion between adjacent segments |
|---|
Interspinous process widening on plain lateral thoracolumbar radiograph after trauma indicates PLC disruption and a potentially unstable injury requiring surgical stabilisation. MRI fluid signal between the spinous processes confirms PLC failure. The TLICS score assigns 3 points to PLC disruption — scores greater than 4 mandate surgery.
Interspinous-supraspinous ligament tearing in thoracolumbar fracture indicating instability and surgical stabilisation requirement.
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