2 The deep fibers of the ALL blend with the periosteum at this point, while the more superficial fibers bridge the concavity. 1,2,3 These fibers form looser, secondary attachments to the mid-portion of the vertebral bodies, filling their concave surfaces and flattening the appearance of anterior surface of the vertebral column. 1,4 These longitudinal fibers attach strongly to the IV discs and the anterior margins of the vertebral bodies. 1,2,4 The superficial fibers are the longest, spanning anywhere from three to five vertebrae, while the intermediate fibers span between two to three vertebrae, and the deep fibers span from one vertebral body to the next, connecting adjacent vertebrae. The ALL consists of numerous collagen fibers that are densely packed and constitute three distinct layers: superficial, intermediate, and deep. 1 The average width of the ALL in the lumbar spine in 25 cadaveric specimens was measured to be 37.1 mm with a mean cross-sectional area of 32.4 mm 2 and a range from 10.6–52.5 mm 2. 1,3 Likewise, it is also thicker and narrower in the thoracic region, as compared to its presence in the cervical and lumbar regions, and broadens as it travels caudally. 1 The ALL is narrower and thicker over the vertebral bodies than when it passes over the intervertebral (IV) discs. 1,2,3,4 The ALL is attached to the basilar occipital bone rostrally, extends to the anterior tubercle of the atlas (C1) as well as the front of the body of the axis (C2), and runs caudally to the anterior of the sacrum. 2-1) is composed of a strong band of collagenous fibers that extends along the anterior aspect of the vertebral column. The anterior longitudinal ligament (ALL) (Fig.
Therefore, disruption of these structures can lead to significant neurological compromise. These highly specialized structures allow for extremes of movement while maintaining alignment of the spinal canal, intervertebral foramina and intervertebral discs. Of these soft tissues, the lumbar vertebral ligaments play a very important role. Shane Tubbs INTRODUCTIONĪs with the other regions of the spine, the lumbar vertebrae rely on a robust collection of soft tissues to maintain their structural integrity during load bearing and movement.
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