[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/) › Supraspinous ligament [Joints and ligaments](https://durgical.com/en/anatomy/system/joints-and-ligaments/) · [Spine](https://durgical.com/en/anatomy/region/spine/) # Supraspinous ligament The supraspinous ligament is a strong cord over the tips of the spinous processes from C7 to the [sacrum](https://durgical.com/en/anatomy/sacrum/); it limits forward bending. [See in 3D →](https://durgical.app/?from=durgipedia&lang=en#region=spine&select=supraspinous_lig&side=r) Opens in the Durgical app, no sign-up needed. ## 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 points - First ligament a midline lumbar puncture needle meets, under the skin and subcutaneous fat - Thin or absent at L5–S1 in many people, where fibres of the thoracolumbar fascia and the erector spinae take its place - The line across the tops of the iliac crests (Tuffier line) crosses about L4 or the L4–L5 space: the landmark for choosing a puncture level below the [conus medullaris](https://durgical.com/en/anatomy/conus-medullaris/) ## Key facts **Attaches** Tips of spinous processes from C7 to sacrum (often ends at L4–L5); continues above as the [nuchal ligament](https://durgical.com/en/anatomy/nuchal-ligament/) **Function** Limits flexion; first spinal ligament stretched in forward bending **Tight in** Flexion ## Relations **Superficial** Subcutaneous fat and [skin](https://durgical.com/en/anatomy/skin/) of the midline of the back **Deep** Tips of the spinous processes and the [interspinous ligaments](https://durgical.com/en/anatomy/interspinous-ligaments/) **Lateral** Posterior layer of the [thoracolumbar fascia](https://durgical.com/en/anatomy/thoracolumbar-fascia/) and the aponeuroses of [trapezius](https://durgical.com/en/anatomy/trapezius-muscle/) and [latissimus dorsi](https://durgical.com/en/anatomy/latissimus-dorsi-muscle/), 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](https://durgical.com/en/anatomy/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](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 - 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. [Add to my cards (4)](https://durgical.app/estudiar/?add=/en/anatomy/supraspinous-ligament/) 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](https://durgical.com/en/anatomy/interspinous-ligaments/) - [Nuchal ligament](https://durgical.com/en/anatomy/nuchal-ligament/) - [C7 vertebra](https://durgical.com/en/anatomy/vertebra-prominens/) - [L1 vertebra](https://durgical.com/en/anatomy/lumbar-vertebra/) - [L2 vertebra](https://durgical.com/en/anatomy/lumbar-vertebra-spine-and-pelvis/) - [L4 vertebra](https://durgical.com/en/anatomy/lumbar-vertebra-spine-and-pelvis-l4/) - [T1 vertebra](https://durgical.com/en/anatomy/t1/) - [T10 vertebra](https://durgical.com/en/anatomy/t10/) 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/supraspinous-ligament/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/anatomy/supraspinous-ligament/