The ligamentum flavum, also known as the ligamentum flavum, is a structure of vital importance for both the stability and dynamic expression of the body in movement. In this post we talk about hypertrophy of the yellow ligament, one of its most common pathologies.
What is the yellow ligament?
The yellow ligaments cover the spaces between the laminae of adjacent vertebrae from the C2 vertebra to the lumbosacral space.
There are two tissues for each cervical, lumbar and dorsal vertebra. Furthermore, the yellow ligaments are placed in pairs, like the laminae, being robust, very elastic to the highest degree and quadrilong in shape.
So, The ligament flavum is made up of a large amount of elastin, a protein composed of desmosine, isodesmosine and peptides exclusive to it. In addition, it contains microfibrils rich in polar amino acids and abundant fibroblasts.
Function of the ligamentum flavum
It can be said that the yellow ligament of the spine performs three functions. Firstly, the ligamentum flavum fixes postural attitudes by reducing muscle expenditure. On the other hand, it restricts mobility, since it passively elongates and retracts due to its elastic capacity that deteriorates over the years. In the last place, the yellow ligament preserves the rest of the vertebral structures.
In this way, when the spine bends forward or to the sides, these yellow ligaments give way. On the other hand, when the spine is aligned and straightened, the elasticity of these ligaments is activated, becoming powerful agents that facilitate this movement.
What is hypertrophy of the yellow ligaments?
Hypertrophy of the ligamentum flavum is a pathological disorder of the spine, in which there is swelling and even degeneration of the ligamentum flavum. This is a fairly common condition in people who have chronic back pain.
The hypertrophy of yellow ligament can cause narrowing of the spinal canal, mainly in patients with spondyloarthrosis and disc and facet degeneration.
Causes of hypertrophy of the yellow ligament
According to studies, it cannot be determined why thickening of the ligamentum flavum occurs, but it is generally observed in patients who have a abnormality in the spinal cord or with a spinal cord injury which appears with age, so the gradual degeneration of the spine begins and finally results in this pathology.
Most cases involving the spinal canal are caused by common pathologies such as degenerative spondylosis, infection, trauma such as a car accident, and metastasis.
Most common symptoms of ligamentum flavum hypertrophy
Hypertrophy of the ligamentum flavum typically presents as persistent lower back or neck pain that worsens with prolonged standing or walking. This pain is caused by compression of the spinal canal due to the thickening of the ligament, as it reduces the space through which the nerves pass. If the pressure increases further, discomfort may radiate to the buttocks or legs, especially during exertion or prolonged periods of standing.
Another very common symptom is morning stiffness or stiffness after inactivity, which is often accompanied by tingling, numbness, or muscle weakness in the lower extremities. In more severe cases, the compression can cause difficulty walking, loss of balance, or a feeling of heaviness in the legs. Therefore, it is essential to see a specialist at the first sign of pain, as early diagnosis significantly improves the prognosis and recovery.
Differences between hypertrophy of the ligamentum flavum and other causes of stenosis
Although spinal stenosis can have various causes, ligamentum flavum hypertrophy is one of the most common in older adults. The problem lies in the thickening of the tissue lining the back of the spinal canal, which leads to progressive compression of the nerve structures.
Conversely, degenerative spondylosis or herniated discs compress nerves due to wear and tear or displacement of the intervertebral discs, not due to ligament thickening. Therefore, magnetic resonance imaging (MRI) is essential to differentiate the cause and plan the most appropriate treatment. In many patients, both conditions can coexist, which is why a comprehensive approach to spinal health is necessary to alleviate symptoms and slow tissue degeneration.
How is ligamentum flavum hypertrophy diagnosed?
The best way to diagnose hypertrophy of the ligamentum flavum or thickening of the ligamentum flavum is with an MRI of the spine. On some occasions, when the patient comes for an MRI to detect pathologies such as hernias or disc bulb, hypertrophy of said ligament can be observed.
When the patient presents symptoms related to the spine, it is important that the specialist ask about the characteristics of the pain that the patient presents. MRI is the most specific test to check the condition of the yellow ligaments of the spine. In addition, the doctor may request complementary tests such as x-rays, where hypertrophy of the facet joints can be observed.
In cases where the patient has a contraindication to performing an MRI, a computed axial tomography will be performed to reach the diagnosis of hypertrophy of the yellow ligament of the spine.
Treatment for hypertrophy of the yellow ligament of the spine
In the stages in which the patient has maximum pain, a short rest is recommended, but it is important to know that prolonged rest may have negative consequences for the spine.
If after a few days, the pain does not disappear, it is important to go to a spinal traumatologist so that he can determine the most appropriate treatment regarding spinal pathologies.
Recommended exercises and habits to relieve pressure on the spine
The treatment for recovery from ligamentum flavum hypertrophy relies on physical rehabilitation and good posture. Stretching and strengthening exercises help maintain flexibility and reduce stress on the spine. Activities such as yoga, Pilates, or swimming are ideal for strengthening muscles, improving posture, and increasing mobility without impact.
It is important to avoid sudden movements or lifting excessive weight, as these can worsen spinal canal compression. Maintaining an exercise routine supervised by a physical therapist helps relieve pain and prevent the condition from progressing. Consistency and daily postural correction are crucial for improving spinal stability and the patient's overall well-being.
Prognosis and recovery after ligamentum flavum surgery
When conventional treatment is ineffective, minimally invasive surgery emerges as an effective option to release the spinal canal and eliminate the compression caused by the hypertrophied ligament. These procedures minimize tissue damage and allow for a faster and safer recovery.
In most cases, patients regain mobility and experience a significant reduction in pain within a few weeks. Postoperative physical therapy is essential for strengthening muscles and improving spinal flexibility. Maintaining an active lifestyle, adopting correct posture, and attending regular check-ups with the specialist are key to preventing relapses and ensuring lasting results.
Minimally invasive surgery for spinal canal
At the Institute of Advanced Spine Surgery we have expert spine traumatologists who have more than 10 years of experience dedicated to pathologies that affect the spine and cause recurrent pain in patients.
In our spine center, we offer the most advanced techniques with the aim of recovering patients' quality of life through minimally invasive spine interventions. The results of these techniques are truly satisfactory, since the consequences for the patient are minor and a rapid recovery of the patient is achieved after the intervention.
If you have any spinal pathology that prevents you from continuing with daily life, do not hesitate to make an appointment with our team. traumatologists and neurosurgeons expert in spinal surgery. Prof. Dr. Elgeadi's team will be looking forward to helping you and putting an end to spinal conditions that worsen the quality of life of the spine.
49 thoughts on “Todo lo que debes conocer sobre la hipertrofia del ligamento amarillo”
I was diagnosed with facet and ligamentum flavum hypertrophy, also diffuse bulging L4-L5, slight bilateral foraminal stenosis and slight protrusion L5-S1 that causes slight central canal stenosis. I am 38 years old and the pain is not always the same, sometimes cramps, other times I have a lot of stress in the hip area, in short, doing my job is difficult for me, and the rheumatologist who treated me told me that my CT is a very normal tac
Good morning, Silvia. Thank you very much for commenting on our blog.
We are extremely sorry for the situation you are in. The most appropriate thing in your case is to consult with a specialist traumatologist, so that through a comprehensive diagnosis they can determine the most appropriate treatment. Do not hesitate to make an appointment with our team of traumatologists at the following link: https://elgeaditraumatologia.com/cita-privada/
All the best.
Hello, I am 65 years old... MRI diagnosis
EVIDENCE IN THE MEDULLARY SIGNAL OF THE SAME COMPATIBLE WITH A DEGENERTIVE PROCESS.
DEGENERATIVE CHANGES OF THE STUDIED SPACES WITH DEHYDRATION OF THE DISCS THAT ARE OVERFLOWING IN A GLOBAL POSTERIOR DIRECTION THAT IMPRINTS ON THE DURAL SAC, SLIGHT HYPERTROPHY OF THE ARTICULAR FACES AND OF THE LIGAMENTUM FLAVUM.
The terminal medullary conus medullaris has a preserved structure, as do its emerging roots. I hope you will answer me. Thank you very much.
Hello, thank you for your message.
The report describes a condition consistent with degenerative changes in the spine, which are common with age: wear and tear and dehydration of the discs, small bulges, and osteoarthritis of the joints, without serious involvement of the conus medullaris or nerve roots, which is a positive finding. These changes can cause pain, stiffness, or limited mobility, but do not always require surgery.
The most appropriate course of action is an in-person assessment to correlate these findings with your symptoms and define the most suitable treatment (pain management, specific physiotherapy, or other options).
If you wish, you can schedule an appointment with our team in Madrid by calling +34 910 053 900. We are at your service.
I had a fall and because of that I stopped defecating for 15 days. My neurosurgeon ordered an MRI of my lumbar spine and diagnosed a 5mm hernia in L4.
8mm in L2
In L4 -L5 of 29mm
Hemangiomas of the vertebral bodies
Summarizing the other bulging vertebrae
The pain persisted and more so in the cervical area, my hands fell asleep, my feet went numb with cramps and pain in my hips.
The cervical MRI showed hypertrophy of the pars articularis in all intervertebral spaces and bulging of the disc in all with contact of the root at the foraminal level and with a decrease in the amplitude of the neuroforamens.
I am 43 years old and my quality of life is reduced, help me understand
Je suis dans le même casi. Des douleurs fenomenal.j ai 62 ans je ne suis fait opérer .j ai était bien 2ans et la Sa recommence je ne dors plus la nuit le matin au levé les douleurs sont déjà là j attend que le médecin dise me à quelle moment je doit I faire opérer pour la dernière fois angiome vertebeaux et canal lombaire rétréci de grade schizas DA étage L3 L 4 j apère avoir des résultats après
Bonjour Herpin,
See our contacts at cliquant ici pour demander un rendez-vous et traiter votre cas en privé.
Greetings
Hi Silvia. Yes, it was during your time working. You should seek legal help.
I have: spondyloarthrosis C4-C5, Uncoarthrosis C4-C5 and C5-C6, C4-C5 Degenerative Discopatias, spondyloarthrosis C6-C7, Degenerative Discopatias C6-C7, Hypertrophy and irregularities of the facet joints at the left C2-C3 level and C5- C5- C5- C6 RIGHT, MULTISEGMENTAL SPONDYLOSIC CHANGE, CERVICOSCOLIOSIS, DEGENERATIVE DISCOPATHIES C6-C7 AND RIGHT FORAMINAL HERNIA C4-C5 THESE ARE FROM THE CERVICAL AREA.
NOW LUMBAR: HYPERTROPHY OF YELLOW LIGAMENTS AND JOINT FACETS, ANNULAR RUPTURE OF THE FIBROUS RING L5-S1, DEGENERATIVE DISCOPATHIES WITH DECREASE IN AMPLITUDE OF THE SPACES L3-L4, L4-L5, L5-S1, BILATERAL SPONDYLOARTHROSSIS L4-S1, L5-S1 , L4-L5. L5-S1 SPONDYLOARTHROSS, LUMBOSACRAL DEGENERATIVE DISCOPATHIES, CENTRAL POSTERIOR DISC BULGE, L3 AND L5 HEMANGEOMA, L5 SACRALIZATION, LUMBOSACRAL DISC BULGE. I AM 61 YEARS OLD AND THIS PAIN IS OF A VERY LONG DISTANCE AND THE NEUROSURGEONS SAY THAT MY SPINE IS VERY OLD AND DEGENERATIVE AND HAS NO SURGICAL MANAGEMENT. CAN YOU PLEASE GIVE ME YOUR OPINION OF MY PATHOLOGIES OF MY COMPLETE SPINE. THANK YOU VERY MUCH IN ADVANCE.
Good morning, Luis Fernando.
Thank you very much for commenting on our blog. In your case, after this diagnosis, the traumatologist will determine the most effective treatment, providing a solution to your pathologies. You can contact our team of spinal traumatologists at the following address: https://elgeaditraumatologia.com/contacto/
All the best.
Hello, I had an MRI because I have pain when I make any effort or stand still, sometimes.
I have lumbosciatica pain, that's why they sent me the study. Lumbar spine Dextroconvex curvature.
The vertebral bodies are correctly aligned and have normal height and signal, coming from
of the bone marrow.
Reduction in height and signal intensity in T2 of the last intervertebral disc.
Asymmetrical bulging of the fifth lumbar disc with left foraminal projection.
The diameters of the lumbar bone canal are within normal limits.
Interface joints without alterations. Hypertrophy of the inferior yellow ligaments.
Conus medullaris with termination at level D12-L1 with normal morphology and signal intensity.
Tarlov cysts in sacral foramina.
Hello, Johanna.
To offer you more detailed information, contact our Madrid traumatologists using the link provided.
All the best.
Good evening, I had an MRI. I have joint pain, I have pain in my lower back, from my hip to my knee.
Anti-inflammatories don't do anything for me. Is there any treatment that will help me?
Vertebral alignment preserved in the sagittal plane.
No signs of bone edema are seen.
Anterior marginal osteophytosis.
Decreased signal from the intervertebral discs compatible with dehydration.
Posterior and medial disc protrusion at L1-L2 and L2-L3 levels.
Posterior disc bulging at L3-L4 and L4-L5 levels.
Right posterior and intraforaminal protrusion at L5-S1 level with tear of the annular fibers.
Hypertrophy of facet joints.
Muscle masses with usual morphology and signal.
The signal coming from the medullary cone and the emerging roots is the usual one.
Diffuse edema of the subcutaneous cellular tissue.
Hello Roxana,
We need more information to understand your clinical profile and to know what type of treatment can be performed in your case.
You can make an appointment at +34 91 005 39 00.
Greetings
Hello, I'm Paula and I have hypertrophy and spondyloarthrosis.
Good morning Paula,
We are very sorry for the situation you are in, so we recommend that you consult with a trusted traumatologist so that he or she can study your case in a personalized way and determine the most appropriate treatment. You can contact our team spinal traumatologists in the link provided.
All the best.
Good morning, my daughter was run over and has a flavium ligament injury c4-5 and c5-6 and compression fracture t1-t7, my question is that neither girl is going to recover.
Hello Raul,
We would have to do a physical exam and look at the evidence. Likewise, we lack a lot of information about the patient to be able to tell you something detailed.
You can contact our team here.
Greetings
Good morning, the CT scan showed yellow ligament hypertrophy in c5 c6
Hello María Alejandra,
Thanks for your comment. In your case, we recommend that you consult with a spine specialist so that he or she can determine the treatment you need to put an end to your pathology. You can contact our expert spine traumatologists in the link provided.
All the best.
Hello, I am from Uruguay, I was diagnosed with bulging discs from L5 to S1, hypertrophy of the yellow ligaments and a narrow hyperfominal canal that I can take to strengthen the ligaments.
Hello Deiby,
Thank you very much for your comment, we are sorry for the situation you are in. For the case you present, we recommend that you consult with a spine specialist beforehand, so that they can determine the most appropriate treatment for your pathology. Do not hesitate to contact our team spinal traumatologists in the link provided.
All the best.
Hello, good morning, I would like to know if, in principle, with exceptions, a disc extrusion at the level of S1 can be operated on by endoscopic surgery.
Thank you
Good morning María Ángeles,
Yes, it could be operated by endoscopic surgery if it produces any neurological compression, although sometimes intradiscal laser is sufficient.
You can request an appointment with our trauma team if you wish.
All the best.
L4-L5 changes in degenerative disc disease with circumferential bulging of the disc that, together with degenerative hypertrophy of facet joints and ligaments flavum, cause mild bilateral lateroforaminal stenosis. At this level it is associated with acute right facet synovitis since it presents edema in the articular margins of the facet joint and in the surrounding soft tissues.
-In L5-S1 severe changes of degenerative disc disease with moderate edema in the medullary bone of both endplates of probable mechanical origin. It is associated with posterior circumferential disc bulging, causing moderate left foraminal stenosis and contact with bilateral L5 root emergence in its predominantly intra- and extraforaminal portions.
Good morning Vanessa,
We have answered your question in the previous comment.
All the best.
I am 44 years old, I have been going to the doctor for a long time without much attention from him. I was diagnosed with restless legs syndrome. I've always had it, but it already has a significant impact on my work and daily life, not to mention the issue of sleep. The neurologist was the one who started the study. I have cramps in my legs and arms, intense pain. There are days when I can't even get out of bed. This is one of the lumbar diagnoses. Cervical and neurophysiology tests are missing. Diagnosis of the lumbar area: sL4-L5 changes of degenerative disc disease with circumferential bulging of the disc that, together with degenerative hypertrophy of facet joints and yellow ligaments, cause mild bilateral lateroforaminal stenosis. At this level it is associated with acute right facet synovitis since it presents edema in the articular margins of the facet joint and in the surrounding soft tissues.
-In L5-S1 severe changes of degenerative disc disease with moderate edema in the medullary bone of both endplates of probable mechanical origin. It is associated with posterior circumferential disc bulging, causing moderate left foraminal stenosis and contact with bilateral L5 root emergence in its predominantly intra- and extraforaminal portions.
Good morning Vanessa,
In order to study your case, you can contact our Madrid traumatologists through the link provided.
All the best.
I am 58 years old and I have: Modic type degenerative change|| in the duperior vertebral plate of L1 and L3 and in the vertebral plates adjacent to the L4-L5 disc. Image suggestive of focus of enostosis in the body of L3. Sign of spondylosis. Disc dehydration L4-L5 Posterior disc bulge L4-L5 that imprints on the ventral surface of the dural sac, projects over the lateral recesses and both foramens, slight right and moderate foraminal obliteration and left. Aniliofibrous fissure is also observed. Slight posterocentral disc bulging L5-S1. The medullary conus is normal in appearance and does not present signal alterations inside. Discrete reduction in the diameter of the canal at level L4-L5 (12.3 × 16.2 mm DAP × DT) Lower lumbar FACETOLIGAMENTARY HYPERTROPHY, fatty infiltration of the posterior paraspinal muscles on the border of the anatomical examination area, partially visualized uterine myomatosis
Good morning Elena,
Thank you for visiting our blog.
In order to study your case and offer you the most appropriate treatment, contact our trauma team.
All the best.
Hello, I'm José, 25 years old. In MRI diagnosis
I get degenerative changes in div l3 l4
Mild hypertrophy of facet joints and flavus ligaments in l3 l4 l5
My pain in my back, and especially in my right leg, when I walk for more than ten minutes, I constantly have to change my posture, because my back can't stand sitting for a long time, too.
I await your response, thank you
Hello Jose,
The normal thing is that it is due to degenerative changes. The ideal is to strengthen the spine, perform functional RHB and medical treatment. But the more you strengthen your spine, the less pain will be. If it doesn't work you will have to go to a consultation for evaluation and see why it doesn't improve.
Greetings
Good morning, I attended a consultation because I had constant pain that began in the thigh of my left leg, other times it hurt in the leg, also behind the knee and numbness in the feet, I had three MRIs, one of the spine and another of the knees because the evaluation also revealed areas to observe in the knees.
The result was canal stenosis due to hypertrophy of the yellow ligament and torn internal menisci in both legs (I clarify that I do not have pain in the knees), the traumatologist considers that I should initially treat the knees by placing hyaluronic acid, platelet infiltrations in the knees, plaque platelet rich in the calcaneal insertion of the left Achilles tendon (due to decalcification in the feet) and the Neuro indicates that the cause that initially brought me to the consultation should be attacked first. My question is: I consider that the result obtained is of importance for my health. I would like to know what you recommend that I should give priority to the spine or knees.
Hello Maria,
In your case we would have to see the imaging tests and analyze what steps to follow. Your case presents some complexity and we need more data to give you an indication of how to move forward.
Greetings
This is my diagnosis by MRI: Extruded disc herniation, thickening of the yellow ligament, bilateral facet degeneration, narrow segmental canal and arachnoiditis
The traumatologist indicates surgery and spinal fixation
the neurosurgeon indicates that there is no need
Which laser is the best procedure and prognosis?
Hello Rachel,
In these cases, it is best for an interdisciplinary team to work together to give you a joint answer on how to move forward.
Greetings
Good afternoon, after 3 spinal operations for lumbar and cervical hernias, I now present with a condition of muscle rigidity that mainly affects my walking since at the first sign of danger or alert, my legs become straight and rigid and my feet do not move. They take off from the ground. Additionally, I lose my balance easily and have to walk looking at the ground to avoid falling. If I look up or turn, I lose my balance immediately. I also have hypersensitivity to the cold and my body starts to shake and get stiff from 19 or 18 degrees Celsius.
Among many neurologists and surgeons that I have visited, they concluded that I have thickening of the yellow ligament, reduction of the lumbar canal, cervical cysts, a herniated disc in the disc adjacent to those already operated on, and in addition they diagnosed me with rigid person syndrome.
I don't know if you can help me review my case remotely (since I don't live in Spain) and give me your point of view, as well as guidance on what steps to follow.
Hello John,
Yes. Please send us an email to [email protected] to ask you for the necessary information and make an appointment.
Greetings
I was diagnosed with hyperlordosis of the lumbosacral hinge with signs of factural overload in L4/L5 and L5/S1
Incipient degenerative discopathy L3 and L4 with mild right posterolateral disc bulging without radicular involvement
Degenerative L5/S1 disc bulging that slightly contacts both S1 root infundibula.
Interapophyseal joints with subchondral facet sclerosis and moderate hypertrophy of the L4/L5 and L5/S1 ligament capsule
Hello Julia,
You can make an appointment at +34 91 005 39 00 so that one of our specialists can review your case personally.
Greetings
I am 29 years old and have a lot of pain in my back and lumbar region.
I was diagnosed with hyperlordosis of the lumbosacral hinge with signs of factural overload in L4/L5 and L5/S1
Incipient degenerative discopathy L3 and L4 with mild right posterolateral disc bulging without radicular involvement
Degenerative L5/S1 disc bulging that slightly contacts both S1 root infundibula.
Interapophyseal joints with subchondral facet sclerotic phenomena and moderate L4/L5 and L5/S1 ligamentous capsule hypertrophy.
Incipient degenerative dehydration of the D8/D9 and D9/D10 discs, stopping as loss of T2 signal from the nucleus pulposus and without prolapse into the spinal canal
Is this serious? What kind of treatment would be needed?
Hello Julia,
We need more information to understand your clinical profile, determine the severity of the case and know what type of treatment you can undergo.
You can make an appointment at +34 91 005 39 00.
Greetings
Good morning, I will tell you about my case. Until now I have been treated for fibromyalgia, which I do suffer from, but now, after many personal limitations due to the pain I suffer and because I was catheterized for 2 months because I stopped urinating on my own, they did an ultrasound and this is the answer: multilevel facet osteoarthritis, severe degenerative disc disease, L5-S1 with changes in the bone marrow, modic type 2 in the end plates of the vertebral bodies adjacent to the degenerative disc, the degenerative disc disease together with the facet osteoarthritis causes moderate bilateral lateroforamidal stenosis. My pain and limitations are horrible.
Hi Amanda,
Your situation seems complex and painful. With facet osteoarthritis and degenerative disc disease, it is important that a multidisciplinary medical team manage your treatment, including pain management options, physical therapy and possibly surgery. You can make an appointment with our specialized team by calling 91 005 39 00.
Greetings
I have a hypertrophy of the yellow ligament in my dorsal region. I honestly don't know what to do to relieve this pain. What suggestions can you give me?
Hello Melissa,
Recommendations depend on each individual case. In order to provide you with appropriate treatment, a doctor from our team will need to evaluate your medical history and any tests you have completed. If you wish, you can schedule an appointment with our team by calling 91 005 39 00, and we will be happy to assist you.
Greetings.
The bad thing is that I am from Peru '(
🙁
Je suffre d une spondyolisthesis opéré il ya 3 ans. The refair window une IRM tant je souffre et on me part of the lower lesions of the yellow ligament with multistage atrophy. J ai également des territoires foraminaux l3 l4 et l4 l5. On me told that all is good hours je n'arrive plus à marcher ni a rester debout 1 mn. De plus j ai fait 5 chutes sur le cou l épaule gauche depuis on me soigne a la pommade, je ne peux plus bouger mes bras jusqu au doigts douleurs vivirs sur les trapèzes et omoplates. Mercy
Hello Marie Helene,
Thank you for sharing your situation. Je comprends votre inquiétude et le level de douleur que vous resentez. After the symptoms that you develop, it is essential to consult a specialist in the vertebral colon or a neurochirurgien, where you need a direct clinical evaluation and approfondie. Même si les exams peuvent sembler peu grave à première vue, vos symptômes indicant qu'une révision Médicale est nécessaire in order to define the treatment the most appropriate and the most useful for you.
Greetings.