The interspinous ligament has a central tendinous band between the more fibrocartilaginous outer portions, running between adjacent spinous processes in the lumbar spine. This central band provides the primary tensile strength of the interspinous complex.
The interspinous ligament tendinous band is the structure implanted around by interspinous spacer devices (X-Stop, Coflex) for lumbar spinal stenosis treatment. Its integrity is assessed by the prone lumbar extension provocation test. Kissing spine syndrome (Baastrup disease) involves degeneration and bursitis at the interspinous tendon complex between adjacent lumbar spinous processes.
Degenerative change in the interspinous ligament tendinous band from contact between adjacent spinous processes in lumbar lordosis producing midline lower back pain worsened by extension, managed with extension restriction and interspinous injection.
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