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. 2023 Apr-Jun;14(2):181-186.
doi: 10.4103/jcvjs.jcvjs_10_23. Epub 2023 Jun 13.

Posterior longitudinal ligament suturation after lumbar discectomy provides postoperative a large intradural area: First report

Osman Ersegun Batcik  1 , Ayhan Kanat  1 , Serdar Durmaz  2 , Bulent Ozdemir  1 , Mehmet Beyazal  3
Affiliations

Posterior longitudinal ligament suturation after lumbar discectomy provides postoperative a large intradural area: First report

Osman Ersegun Batcik et al. J Craniovertebr Junction Spine. 2023 Apr-Jun.

Abstract

Background: Stability and flexibility of the spine are provided by the posterior longitudinal ligament (PLL). It plays a key role in the pathogenesis of lumbar disc herniation (LDH) by preventing disc protrusion. The effect of the suturing of the PLL on the intradural area was investigated.

Patients and methods: The patients were included in whom lumbar microdiscectomy was performed between January 2021 and July 1, 2022. The patients were randomly divided into two groups as PLLs were sutured and unsutured.

Results: Forty-six (23 males and 23 females) patients were included. The PLLs were sutured in 22 patients (Group 1) and not sutured in 24 patients (Group 2). The levels, sides of LDHs, and ages and gender of patients were also analyzed in both groups, which were not statistically significant. Preoperative mean spinal intradural areas were 77.29 mm2 for the PLL unsutured group and 85.40 mm2 for the PLL sutured group (Groups 1 and 2). For patients in Groups 1 and 2, the postoperative mean spinal intradural areas grew to 134.73 mm2 and 96.12 mm2, respectively. The difference in preoperative mean spinal intradural regions between the two groups was not statistically significant; however, Group 1 showed a substantial difference (sutured PLL patients).

Conclusions: This study first time indicates that suturing PLL has a protective and supportive role in patients who were operated on for LDH.

Keywords: Low back pain; lumbar disc herniation; posterior longitudinal ligament.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Preoperative Sagittal T2 (a), Axial T2 (b), weight images of the intradural area of a patient with L3–4 LDH before suturing of PLL. The intradural area was measured as 101.563 mm2. LDH: Lumbar disc herniation, PLL: Posterior longitudinal ligament
Figure 2
Figure 2
After suturing of PLL during surgery, (a) Sagittal, (b) Axial. Postoperative MRI of patient are seen; The intradural area was increased to 187.201 mm2. PLL: Posterior longitudinal ligament
Figure 3
Figure 3
Preoperative sagittal T2 (a), axial T2 (b) weight images of the intradural area of a patient with right 4–5 LDH before surgery. The intradural area was measured as 82.4219 mm2. LDH: Lumbar disc herniation
Figure 4
Figure 4
(a) Sagittal, (b) Axial. Show postoperative MRI of patient without suturation of PLL: The intradural area was moderately increased to114.136 mm2. PLL: Posterior longitudinal ligament
See this image and copyright information in PMC

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