[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Anatomy](https://durgical.com/en/anatomy/) › [Spine](https://durgical.com/en/anatomy/region/spine/) › Interspinous ligaments [Joints and ligaments](https://durgical.com/en/anatomy/system/joints-and-ligaments/) · [Spine](https://durgical.com/en/anatomy/region/spine/) # Interspinous ligaments The interspinous ligaments are thin sheets between neighbouring spinous processes, the bumps down the back; they limit forward bending. [See in 3D →](https://durgical.app/?from=durgipedia&lang=en#region=spine&select=interspinous_ligs&side=r) Opens in the Durgical app, no sign-up needed. ## What it is Thin sheets of ligament between neighbouring spinous processes (the bumps you feel down your back). ## What it does Limit forward bending and separation of the spinous processes. ## Key points - Second ligament a midline lumbar puncture needle crosses, after the supraspinous ligament and before the ligamentum flavum; it feels firm - Part of the posterior ligamentous complex (supraspinous and interspinous ligaments, ligamentum flavum, facet capsules); its disruption after trauma signals instability - Fanning (widening) of the gap between two spinous processes on a lateral view suggests a tear after a flexion injury ## Key facts **Attaches** Between adjacent spinous processes, root to tip; blend with ligamentum flavum in front and supraspinous ligament behind; thin in neck, strong in lumbar region **Function** Limit flexion and separation of spinous processes **Tight in** Flexion ## Relations **Course** Midline needle path: after the [skin](https://durgical.com/en/anatomy/skin/), fat and [supraspinous ligament](https://durgical.com/en/anatomy/supraspinous-ligament/), the needle crosses it before reaching the [ligamentum flavum](https://durgical.com/en/anatomy/ligamenta-flava/) **In front** Ligamentum flavum and, beyond it, the posterior epidural space **Behind** Supraspinous ligament, then fat and skin **Lateral** [Interspinales muscles](https://durgical.com/en/anatomy/interspinales-muscles/) and [multifidus](https://durgical.com/en/anatomy/multifidus-muscles/) on each side ## How to find it Felt only indirectly: with the trunk bent forward, a fingertip pressed into the gap between two lumbar spinous processes lies over it, deep to the supraspinous ligament. This gap is the midline entry point for lumbar puncture. ## On imaging Sagittal fat-suppressed MRI (STIR) shows high signal from oedema or tearing after a flexion injury. The lateral radiograph shows widening between spinous processes; X-rays and CT show contact between them in kissing spines (Baastrup disease). ## Common problems - Strain or tears in flexion injuries; 'kissing [spine](https://durgical.com/en/anatomy/region/spine/) ' (Baastrup) when the processes rub in older adults. ## How it is diagnosed MRI for ligament injury; X-rays and CT for kissing spines. ## Treatment - Usually physical therapy and pain medicine; injections for Baastrup's disease. ## Clinical notes - In flexion-distraction (Chance-type) injuries it tears with the rest of the posterior ligamentous complex; MRI evidence of this guides decisions about stability - When the ligaments are calcified or the spinous processes crowd together, a paramedian approach for lumbar puncture avoids the supraspinous and interspinous ligaments - Interspinous spacers placed between spinous processes for neurogenic claudication sit in the space this ligament fills ## Test yourself Think of the answer, then tap the question to see it. ## In a midline lumbar puncture, when does the needle cross the interspinous ligament? Second: after the supraspinous ligament and before the ligamentum flavum; it feels firm. ## Which structures form the posterior ligamentous complex that includes the interspinous ligaments? The supraspinous and interspinous ligaments, the ligamentum flavum and the facet capsules; its disruption after trauma signals instability. ## Which lateral X-ray sign suggests an interspinous ligament tear after a flexion injury? Fanning: widening of the gap between two spinous processes. ## What is Baastrup disease, in the region of the interspinous ligaments? «Kissing spine»: adjacent spinous processes rub together in older adults; X-rays and CT show the contact. [Add to my cards (4)](https://durgical.app/estudiar/?add=/en/anatomy/interspinous-ligaments/) Educational information, not medical advice. For any symptom, see a health professional. ## Its names **Official Latin (TA2)** ligamenta interspinalia TA2 1674 **Official Spanish (DeCS)** Ligamentos interespinosos **English (TA2)** Interspinous ligaments ## Related - [Supraspinous ligament](https://durgical.com/en/anatomy/supraspinous-ligament/) - [Interspinales](https://durgical.com/en/anatomy/interspinales-muscles/) - [Atlas (C1)](https://durgical.com/en/anatomy/atlas/) - [Axis (C2)](https://durgical.com/en/anatomy/axis/) - [C3 vertebra](https://durgical.com/en/anatomy/cervical-vertebrae/) - [C4 vertebra](https://durgical.com/en/anatomy/c4/) - [C5 vertebra](https://durgical.com/en/anatomy/c5/) - [C7 vertebra](https://durgical.com/en/anatomy/vertebra-prominens/) Sources: Terminologia Anatomica (TA2); [Anatomy, Back, Lumbar Spine](https://www.ncbi.nlm.nih.gov/books/NBK557616/); [Anatomy, Back, Posterior Longitudinal Ligament](https://www.ncbi.nlm.nih.gov/books/NBK560691/). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/anatomy/interspinous-ligaments/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/anatomy/interspinous-ligaments/