Degenerative changes in the interspinous ligament.

Objective: The aim of this study was to investigate the imaging assessment of interspinous ligament degeneration (ISLD) in patients with or without low back pain (LBP).

Methods: Sixty patients with LBP were enrolled in Group A and 60 subjects frequency-matched by age and sex in Group B. An MRI-based grading system for ISLD was scored and ranged from Type A (normal) to Type D (severe). The lumbar disc was also graded according to degeneration at four lumbar levels.

Results: Type A ISLD was the most prevalent type with 161 levels (67.1%) in Group A and 172 (71.7%) in Group B. Type D was the least frequent, seen in 13 levels in Group A and 3 in Group B. There was a significantly higher incidence of Type D ISLD in Group A than Group B (5.4% vs. 1.3%, p<0.05). The average age of patients with Type D ISLD in Group A was higher than Types A, B and C (Type A and B p<0.01, Type C p<0.05). In Group B, the age of patients with Type D ISLD was significantly higher than those with Type A (p<0.05). Although disc grade increased in advanced ISLD in both groups, only the difference between Type D and Types A and B in Group A were statistically significant (p<0.05).

Conclusion: More advanced ISLD grades were less common in patients with or without LBP. Advanced change of the ISL was more common in patients with LBP. ISLD occurred in more severe disc degeneration.