Epidural ligaments

Last revised by Matt Skalski on 26 Jan 2019

The epidural ligaments, also known as meningovertebral ligaments, are variably thick bands of connective tissue located within the spinal epidural space attaching the outer surface of the theca to the inner borders of the spinal canal (vertebrae and ligaments). 

They are somewhat variable in number and location, although some are more consistently identified:

  • anterior epidural ligaments (of Hofmann)
    • midline: between the anterior theca and the middle of the posterior longitudinal ligament (sometimes known as Trolard's ligaments 2) - in the sagittal plane
    • lateral: between the anterolateral theca and the lateral extent margin of the posterior longitudinal ligament
    • proximal root sleeve: between the nerve root sheath and the posterior longitudinal ligament and the inferior pedicle (not originally described by Hofmann 1
  • lateral epidural ligaments - in the coronal plane
  • posterior epidural ligaments 
    • midline: between posterior theca and ligamentum flava or spinal lamina (also known as the posteromedian fold of the dura mater or "plica mediana dorsalis”) - in the sagittal plane
    • posterolateral

These ligaments result in tethering of the dura when it is pushed (e.g. Y-sign of epidural lipomatosis - see case 1) or pulled (e.g. festooned dura of craniospinal hypotension) inwards 3.

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Cases and figures

  • Figure 1: illustration
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  • Case 1
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