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A comparative study of the anatomy and MRI images of the lumbar foraminal ligaments at the L1–L5 levels

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Abstract

Purpose

The purpose of this study was to evaluate the ability of MRI images to reveal foraminal ligaments at levels L1–L5 by comparing the results with those of anatomical studies.

Methods

Eighty lumbar foramina were studied. First, the best MRI scanning parameters were selected, and the transverse and sagittal axes of each lumbar foramina were scanned to identify and record the ligament-like structures in each lumbar foramen. Then, the cadaveric specimens were anatomically studied, and all ligament structures in the lumbar foramina were retained. The number, morphology and distribution of ligaments under anatomical and MRI scanning were observed. Histological staining of the dissected ligament structures was performed to confirm that they were ligamentous tissues. Finally, the accuracy of ligament recognition in MRI images was statistically analyzed.

Results

A total of 233 foraminal ligaments were identified in 80 lumbar intervertebral foramina through cadaveric anatomy. The radiating ligaments (176, 75.5%) were found to be attached from the nerve root to the surrounding osseous structures, while the transforaminal ligaments (57, 24.5%) traversed the intervertebral foramina without any connection to the nerve roots. A total of 42 transforaminal ligament signals and 100 radiating ligament signals were detected in the MRI images of the 80 intervertebral foramina.

Conclusion

The MRI can identify the lumbar foraminal ligament, and the recognition rate of the transforaminal ligament is higher than that of the radiating ligament. This study provides a new method for the clinical diagnosis of the relationship between the lumbar foraminal ligament and radicular pain.

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Data availability

Data is available for reviewing upon request.

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Acknowledgements

The authors thank their families for their support of this study and the contributors of human specimens.

Funding

This study has been supported by grants from the Foundation for Basic and Applied Basic Research of Guangzhou (Grant No. 202201011203), Foundation for Basic and Applied Basic Research of Guangzhou (Grant No.SL2022A04J01494) and National Natural Science Foundation of China (Grant No.32200946).

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Authors and Affiliations

  1. Guangzhou Women and Children’s Medical Center, No. 9 Jinsui Road, Guangzhou, 510000, China

    Enyi Zhong

  2. Department of Orthopedics, The Third Affiliated Hospital of Southern Medical University, No. 183, Zhongshan Rd West, Guangzhou, 510630, China

    Enyi Zhong, Chaohui Fan, Qingchu Li & Qinghao Zhao

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  1. Enyi Zhong
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  2. Chaohui Fan
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  3. Qingchu Li
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  4. Qinghao Zhao
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Contributions

QH Zhao and QC Li: project development. EY Zhong and QH Zhao: data collection or management, manuscript writing/editing. CH Fan: data analysis.

Corresponding author

Correspondence to Qinghao Zhao.

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Zhong, E., Fan, C., Li, Q. et al. A comparative study of the anatomy and MRI images of the lumbar foraminal ligaments at the L1–L5 levels. Surg Radiol Anat 45, 1535–1543 (2023). https://doi.org/10.1007/s00276-023-03251-3

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  • DOI: https://doi.org/10.1007/s00276-023-03251-3

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