What Is The Function Of Ligaments In The Skeletal System – It started as a dull ache and now it has progressed. It feels like a knife in the back of your neck and prevents you from daily activities. Medicines, rest and conservative treatments failed. Your doctor noticed on the X-ray that the bones are not aligned. He thinks you may have suffered a ligament injury. What is a link? What is the function of ligaments in the Spinal Column? What are the 5 main joints of the Spine? Are there different types of ligament injuries? What can happen if the ligaments of the spine are injured? Can ligaments heal on their own? What are the treatment options for spinal ligament injuries? Let’s dig deeper.

A ligament is a thick piece of connective tissue that connects bone to bone. Think of it like duct tape that holds the bones together.

What Is The Function Of Ligaments In The Skeletal System

Ligaments work to stabilize the Spine, hold the Vertebral bodies together, limit movement of the Spine and protect the Discs (1).

Dr Terence Moopanar

Reviewing the basic anatomy of the spine will help you better appreciate the major ligaments of the Spine and their location. In this post I will discuss the cervical spine: AKA the neck. All of the ligaments discussed below are located in the cervical spine, but actually run the length of the spine to the sacrum.

The Vertebral Column is made up of building blocks of bones that are stacked on top of each other. These are called vertebral bodies. In the cervical spine there are 7 bony building blocks numbered 1 to 7.  Before them is the letter “C” which refers to the Cervical. Between each of the structural elements is a spongy shock absorber called a Disc. At each level of the spine, nerves exit through a bony opening called a foramen.

There are a large number of both large and small ligaments in the Spinal Column. The 5 main ligaments of the Spine include:

A thin one-inch ligament located at the front of the Spine. It starts at the base of the skull and extends into the pelvis. To learn more about the Anterior Longitudinal Ligament, click here.

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A thin one-inch ligament located at the back of the bones of the vertebral column (Vertebral bodies). Like ALL, PLL starts at the base of the skull and extends into the pelvis.

At the back of the Spinal Column there is a prominent bone that is easily felt. It is present at every level and is located in the midline. If you run your hand down someone’s neck, these pointy bones are easily identified. These are the Spinous Processes. The supraspinous ligament connects each of the spinous processes from C7 to L4.

Like the Supraspinous Ligament, the Interspinous Ligament connects each of the Spinous Processes of the Spinal Column. It is slightly deeper than the Supraspinous Ligament. Its most superficial fibers are connected to the Supraspinous Ligament while the deeper fibers are connected to the Ligamentum Flavum. Conceptually it lies between the Supraspinous Ligament and the Ligamentum Flavum

Ligamentum Flavum is a thick ligament that connects the vertebral bodies together. Specifically, the Lamina connects two adjacent Vertebral bodies. It is sandwiched between the Intervertebral Ligament and the Meninges. It starts at the C2 bone and extends down into the pelvis. It is an important milestone for anesthesiologists when they advance their needle for epidural injections. The Ligamentum Flavum is thick and there can be a significant change in needle pressure when advanced into the Ligamentum Flavum. The technique is called Loss of Resistance (LOR). The Ligamentum Flavum can increase in thickness causing a narrowing of the spinal canal, a condition known as Spinal Stenosis.

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Ligaments in the spine are prone to injury. Car accidents, sports injuries, other traumatic events, and repetitive motions over time are the most common causes of ligament injuries (2)

Absolutely! Various types of trauma, including car accidents that can cause ligament injury. These injuries are classified into three grades.

Grade 2 sprain: More severe and involves a partial full-thickness tear, but the ligament remains intact.

Grade 3 sprain: The most serious and involves the entire ligament. The two ends of the link are pulled apart. This is otherwise known as a rupture.

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Spinal ligaments provide significant stability, limit movement and protect the vertebral discs. Spinal ligament injury is classified based on the severity of the ligament injury. Spinal ligament injury can cause any of the following.

Spinal instability: The bones of the spine stack on top of each other. They are supported by Vertebral Ligaments. Injury to these ligaments can cause movement of one or more Vertebral Bodies (building blocks of bones). This is referred to as Listhesis. If the bone moves forward in relation to the adjacent bone it is called Antislip. Conversely, if the bone moves backwards relative to the adjacent bone, it is called Reversion.

Disc Injury: The movement of the vertebral bodies creates a shearing force on the disc. This force can lead to disc irritation, injury and degeneration. Additionally, the loss of support provided by the ligament can cause disc protrusions or herniations.

Nerve Injury: Movement of one or more Vertebral Bodies can also irritate the outgoing nerve roots causing radiating pain in the extremities, numbness and tingling.

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Facet Injury: Instability of the ligaments in the spine can lead to overload, irritation and injury to the facet which in turn can lead to debilitating pain

Yes! Magnetic resonance imaging is an effective radiographic study for evaluating spinal ligament injuries (3). Common findings include blood or swelling next to the torn ligament.

Healing depends on the severity of the injury. Ligament healing is an extensive 3-phase process that takes months. If a given ligament is allowed sufficient time to heal and supported during the healing phase, many Grade 1 injuries can heal. The problem with spinal ligament injuries is twofold:

External support is not a practical option. Unlike a knee or ankle ligament injury where a knee or ankle brace may be applied, external spinal braces are rarely used and poorly tolerated by most patients.

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At the Centeno-Schultz Clinic, treating spinal ligaments is a central part of our treatment philosophy and protocol. We think of the Spine as a collection of many parts that work in a synchronized manner. This approach is known as a Functional Spinal Unit (FSU) and is radically different from the approach used in most pain clinics which focus on one or more ‘Generators of Pain’. To learn more about this approach, click here.

Spinal ligament injuries can be treated with precise injections of PRP or bone marrow concentrate under x-ray or ultrasound guidance. Blind injections are below our standard of care and put the patient at risk for nerve, disc and vascular injuries. The injections are demanding and cannot be given by your Orthopedic or Family Doctor. Below is an x-ray image of a Median Ligament injection at C2. Below is an x-ray image of a Cervical Medial Ligament injection from my clinic. It was performed under radiological guidance in a patient with cervical instability. .

Ligaments take time to heal after PRP or bone marrow concentrate injections. There are three distinct phases: inflammatory, proliferative and tissue remodeling. To learn more about healing ligaments click on the video below.

If you or a loved one has suffered a spinal cord injury that has not responded to conservative treatment, schedule a Telemedicine consultation. Spinal ligament injuries are quite common and often overlooked, leading to Spinal Instability and injury to Spinal Discs, Facets and Nerves. Stop the hassle and learn about your regenerative options from a board-certified, trained physician today.

Inguinal Ligaments (human Anatomy): Image, Functions, Diseases And Treatments

1.Damm N, Rockenfeller R, Gruber K. Lumbar spinal ligament characteristics extracted from step reduction experiments allow more accurate modeling than literature data. Biomech Model Mechanobiol. 2020? 19(3): 893-910. doi:10.1007/s10237-019-01259-6

2.Punjabi MM. A chronic back pain hypothesis: subligamentous insufficiency injuries lead to muscle control dysfunction. Eur Spine J. 2006;15(5):668-676. doi:10.1007/s00586-005-0925-3

3.Katzberg RW, Benedetti PF, Drake CM, Ivanovic M, Levine RA, Beatty CS, Nemzek WR, McFall RA, Ontell FK, Bishop DM, Poirier VC, Chong BW. Acute cervical spine injuries: a prospective evaluation of MR imaging in a level 1 trauma center. Radiology. 1999 Oct;213(1):203-12. doi: 10.1148/radiology.213.1.r99oc40203. PMID: 10540663.

Download your free copy of Dr. Centeno on spine health and how Interventional Orthopedics can help you avoid life-changing surgery. The anterior cruciate ligament (ACL) is one of a pair of cruciate ligaments (the other being the posterior cruciate ligament) in the human knee. The two links are also called “cruciate” links, as they are arranged in a cross formation. The quadrupedal stifle joint (analogous to the knee), based on its anatomical location, is also referred to as the cranial cruciate ligament.

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The term crucifix translates to cross. This name is appropriate because the ACL crosses the posterior cruciate ligament to form an “X.” It is made of strong, fibrous material and helps control excessive movement. This is done by limiting the mobility of the joint. The anterior cruciate ligament is one of the four major ligaments of the knee, providing 85% of the force limiting anterior tibial displacement at 30 and 90° of knee flexion.

The ACL originates deep within the groove of the distal femur. Its proximal fibers flutter

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