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The lumbosacral ligament (LSL), with special emphasis on the “lumbosacral tunnel” and the entrapment of the 5th lumbar nerve

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Summary

The lumbo-sacral ligament (LSL) was studied in 42 specimens. It extends from the L5 vertebra to the ala of the sacrum and forms, with the structures to which it is attached, an osteofibrotic tunnel as an extension of the intervertebral foramen. The 5th lumbar nerve root passes through the tunnel over the ala of the sacrum and behind the LSL. A branch of the 4th lumbar nerve root passes in front of the LSL to join the 5th below the ligament to form the lumbo-sacral trunk. The sympathetic ramus communicans to the L5 root always penetrates the LSL at its superior border and reaches the nerve inside the tunnel. Branches of the ilio-lumbar vessels accompany the L5 root. Large osteophytes on the inferior border of L5 and tightness of the LSL were often found to cause entrapment and compression of the L5 nerve root against the ala of the sacrum.

Résumé

Le ligament lombo-sacré (LSL) a été étudié sur 42 spécimens anatomiques. Il s'étend de la 5ème vertèbre lombaire à l'aileron sacré pour former, avec les structures auxquelles il se rattache, un canal ostéo-fibreux qui prolonge le trou de conjugaison correspondant. La 5ème racine lombaire traverse ce canal au-dessus de l'aileron sacré et en arrière du LSL. Un rameau anastomotique de la 4ème racine lombaire passe en avant du LSL et rejoint la 5ème racine lombaire pour former le tronc lombo-sacré. Le rameau sympathique communicant pénètre le bord supérieur du LSL pour s'unir au nerf à l'intérieur du canal. La 5ème racine lombaire est accompagnée par des branches des vaisseaux ilio-lombaires. Des ostéophytes développés à partir du bord inférieur de L5, de même que la tension du ligament sont assez souvent la cause de l'irritation et de la compression de la 5ème racine lombaire contre l'aileron sacré.

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Authors and Affiliations

  1. Department of Anatomy and Anthropology, Sackler School of Medicine, Tel Aviv University, Ramat Aviv, Israel

    Hilel Nathan, Marcos Weizenbluth & Nahum Halperin

  2. Department of Orthopaedics and Traumatology “A”, Government Hospital, ‘Assaf Harofe’, Tzrifin, Israel

    Marcos Weizenbluth & Nahum Halperin

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  1. Hilel Nathan
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  2. Marcos Weizenbluth
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  3. Nahum Halperin
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Nathan, H., Weizenbluth, M. & Halperin, N. The lumbosacral ligament (LSL), with special emphasis on the “lumbosacral tunnel” and the entrapment of the 5th lumbar nerve. International Orthopaedics 6, 197–202 (1982). https://doi.org/10.1007/BF00267730

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