The thoracic supraspinous ligament connects the tips of thoracic spinous processes from C7 to the sacrum, forming the posterior-most restraint against spine flexion.
Provides the most posterior element of the flexion restraint system, acts as the outermost component of the posterior tension band, and contributes to spinal erector muscle force transmission through its fascial connections.
The supraspinous ligament is palpable as the cord between the spinous process tips — its gap (interspinous tenderness) indicates disruption. In interspinous device implantation (X-Stop, Coflex) for lumbar spinal stenosis, the supraspinous ligament is preserved as the posterior anchor.
Avulsion of the supraspinous ligament in lumbar flexion-distraction (Chance) injury producing interspinous gap palpable on examination, requiring posterior fusion.
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