Supraspinous ligament !
The supraspinous ligament is a strong cord over the tips of the spinous processes from C7 to the sacrum; it limits forward bending.
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What it is
A strong cord running over the tips of the spinous processes from C7 to the sacrum.
What it does
Joins the tips of the spinous processes and limits forward bending; it is the first ligament stretched when you bend forward.
Key facts
- Attaches
- Tips of spinous processes from C7 to sacrum (often ends at L4–L5); continues above as the nuchal ligament
- Function
- Limits flexion; first spinal ligament stretched in forward bending
- Tight in
- Flexion
Relations
- Superficial
- Subcutaneous fat and skin of the midline of the back
- Deep
- Tips of the spinous processes and the interspinous ligaments
- Lateral
- Posterior layer of the thoracolumbar fascia and the aponeuroses of trapezius and latissimus dorsi, which blend into it
How to find it
With the person sitting and bent forward to open the spaces, it is felt as a firm midline cord over the tips of the spinous processes. Counting usually starts from the vertebra prominens (C7, sometimes T1) going down, or from the Tuffier line going up.
On imaging
Sagittal MRI shows a dark band over the spinous process tips; high signal or a break in it is part of a posterior ligamentous complex injury.
Common problems
- Strain or tears in flexion injuries; 'kissing 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
- After trauma, a palpable gap or step between two spinous processes suggests the posterior ligaments are torn
- The midline incision of posterior spine surgery divides it; repairing it at closure helps restore the posterior tension band
- In older people it may be calcified, making the midline needle approach harder
Test yourself
Think of the answer, then tap the question to see it.
Where does the supraspinous ligament run, and what does it continue as above?
Over the tips of the spinous processes from C7 to the sacrum (often ending at L4–L5); above C7 it continues as the nuchal ligament.
Which ligament does a midline lumbar puncture needle meet first?
The supraspinous ligament, under the skin and subcutaneous fat.
What landmark is used to choose a lumbar puncture level along the supraspinous ligament?
The Tuffier line across the tops of the iliac crests, which crosses about L4 or the L4–L5 space, below the conus medullaris.
After trauma, what does a palpable gap or step along the supraspinous ligament suggest?
That the posterior ligaments are torn between those two spinous processes.
Educational information, not medical advice. For any symptom, see a health professional.
Its names
- Official Latin (TA2)
- ligamentum supraspinale TA2 1677
- Official Spanish (DeCS)
- Ligamento supraespinoso
- English (TA2)
- Supraspinous ligament
Related
- Interspinous ligaments
- Nuchal ligament
- C7 vertebra
- L1 vertebra
- L2 vertebra
- L4 vertebra
- T1 vertebra
- T10 vertebra
Sources: Terminologia Anatomica (TA2); Anatomy, Back, Lumbar Spine; Anatomy, Back, Posterior Longitudinal Ligament.
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Representative model, for educational purposes only.
