Transforaminal ligaments are accessory fibrous bands crossing the intervertebral foramina of the lumbar spine, forming one to four distinct bands that subdivide the foramina into compartments. They are present in up to 47% of lumbar levels.
Subdivide the intervertebral foramen into separate compartments for the nerve root, dorsal root ganglion, and radicular vessels. May protect or compress neural structures depending on their position relative to the exiting nerve root.
Transforaminal ligaments are a clinically important but underrecognised cause of foraminal nerve root compression — they produce radicular symptoms not explained by disc herniation or bony stenosis on standard imaging. Endoscopic foraminal decompression that includes division of these bands produces better outcomes than root decompression alone.
Fibrous band crossing the lumbar foramen compressing the exiting nerve root producing unexplained radiculopathy, identified at endoscopic foraminotomy and divided for decompression.
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