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Spine J. 2015 Jun 1;15(6):1325-31. doi: 10.1016/j.spinee.2013.07.483. Epub 2013 Oct 17.

The molecular composition of the extracellular matrix of the human iliolumbar ligament.

Author information

1
AO Research Institute, AO Foundation, Clavadelerstrasse 8, CH-7270 Davos, Switzerland.
2
AO Research Institute, AO Foundation, Clavadelerstrasse 8, CH-7270 Davos, Switzerland; Department of Orthopaedic Surgery, Nara Medical University, 840 Shijo-cho, Kashihara-shi, Nara, 634-8522, Japan.
3
The Centre for Spinal Studies and Surgery, Queen's Medical Centre Campus, Derby Rd, West Block D Floor, Nottingham University Hospitals NHS Trust, Nottingham, NG7 2UH, United Kingdom.
4
Institute of Legal Medicine, University of Rostock, St.-Georg-Straße 108, DE-18055 Rostock, Germany.
5
Cardiff School of Biosciences, Museum Ave, Cardiff, CF10 3AX, United Kingdom.
6
AO Research Institute, AO Foundation, Clavadelerstrasse 8, CH-7270 Davos, Switzerland; Anatomische Anstalt, Ludwig-Maximilians-University, Pettenkoferstr. 11, DE-80336 Munich, Germany. Electronic address: stefan.milz@med.uni-muenchen.de.

Abstract

BACKGROUND CONTEXT:

The human iliolumbar ligament connects the transverse process of L5 to the iliac crest and contributes to lumbosacral stability and has been associated with low back pain. However, different opinions exist regarding the functional relevance of the ligament.

PURPOSE:

In the present study, we analyze the regional molecular composition of the ligament extracellular matrix.

STUDY DESIGN:

Special attention is given to the attachment sites, to determine whether the ligament is subjected to a certain mechanical environment.

METHODS:

Iliolumbar ligament samples, extending from one enthesis to the other, were removed from 11 cadavers and fixed in methanol. Cryosections were immunolabeled with a panel of antibodies directed against collagens, glycosaminoglycans, proteoglycans, matrix proteins, and neurofilament.

RESULTS:

The mid-substance of the ligament labeled for all the molecules normally found in dense fibrous connective tissue including types I, III, and VI collagen, versican, dermatan -, chondroitin 4 -, and keratan sulfate. However, both entheses were fibrocartilaginous and labeled for type II collagen, aggrecan, and chondroitin 6- sulfate. A common feature was fat between the fiber bundles near the entheses. Occasionally this fat contained nerve fibers.

CONCLUSIONS:

The existence of fibrocartilaginous entheses suggests that the insertion sites of the ligament are subject to both tensile and compressive loading-probably because of insertional angle changes between ligament and bone during loading. Our findings support the suggestion that the iliolumbar ligament might play an important role in the stabilization of the lumbosacral junction.

KEYWORDS:

Attachment; Enthesis; Insertion; Lumbosacral junction; Type II collagen

PMID:
24139866
DOI:
10.1016/j.spinee.2013.07.483
[Indexed for MEDLINE]

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