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A D V E R T I S E M E N T
A D V E R T I S E M E N T
The facets of adjacent vertebrae are enclosed by inner synovial membranes and outer joint capsules. The joint capsule and adjacent lateral edge of ligamentum flavum form the posterior borders of the intervertebral foramina.
A D V E R T I S E M E N T
The patient was taken to the operating room for L4 laminectomy to relieve compressive symptoms. The incision was marked, and the two center cross lines represent the presumed spinous process of L4. The incision was deepened, and the paraspinous muscles were separated from the sides of the spinous process down to lamina.
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A D V E R T I S E M E N T
The lumbar part of the paraspinous muscles receive their blood supply from the lumbar arteries coming off the aorta. The intervertebral disks consist of a strong annulus fibrosis, and a gelatinous central nucleus pulposis. Disruption of the annulus, usually posterolaterally, may impinge on the nerves emerging through the intervertebral foramina. Posterior herniation at the L5-S1 level in this case compounds the compression from osteoarthritic spinal canal stenosis. Because of the L5 arch malformation and the potential for instability with surgical decompression at that level, only the L4 laminectomy was planned as a first stage (and possibly only) attack on the problem. Note the supraspinous and interspinous ligaments connecting adjacent spinous processes. The interspinous ligaments are continuous with the ligamenta flava below.
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This page was last modified on 1/22/2002.
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