Longitudinal Ligament Question

[bmills]

Looking for info on how the longitudinal ligament works in the spine.

It has to be dissected at the ADR level.

My surgery report noted that my longitudinal ligament was found to be 'incompetent' which must mean it was especially bad.

Here is the question: Does the longitudinal ligamet remain 'normal' and continue to provide spinal support for all the other levels after ADR?

I've placed a call on it to my surgeon but want to know what members have info on it.

Thanks.

Brady

[luvmysibe]

Good question, now I'll have to ask my specialist and check back here for an answer.

[mmglobal]

Think of the anterior and posterior longitudinal ligament as a broad piece of strapping tape that runs down the front or back of your spine. When they expose the spine, a healthy ALL looks all white and glistening and you can see the longitinal fibers... just like in the strapping tape.

Rarely, I've seen where the ALL is all pink and swollen with inflammatory tissue. I've seen where nerves that don't belong there have grown into the ALL, potentially making the anterior problem very painful. Many, many of the surgeons I know, still maintain that anteriror disc herniations are not painful. Patients I've seen with this huge inflammatory response seem to be the patients who can tell at just a few days post-op that certain movements or positions that used to be painful are no longer painful.

There may also be an anterior disc herniation that compromises the ALL, but it's hard for me to imagine this compromising enough of the ligament to call it incompetent. Also, the ligament is somewhat redundant as evidenced by the fact that many of us have had our ALL and PLL removed at our ADR level. Perhaps an incompetent ligament in conjunction with other factors that contribute to instability would give us a double-whammy that could be problematic.

More likely would be problems with the PLL. Multiple disc herniations, posterior surgeries, severe disc collapse (usually posterior first), etc... could all contribute to shred the PLL and make it useless at that level. I'd be surprised to discover that a problem with the ligament at one level would effect it's comptence at another. It is very seriously glued to the vertebral bodies. Having said that... multi-level disease could certainly make it incompetent at more than one level.

Mark