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Updated: May 14, 2026

Laminectomy for the Removal of Thoracic Ossification of the Ligamentum Flavum (TOLF) Using Ultrasonic and Conventional Osteotomes
Published on: April 21, 2023
Contemporary views on the ossification of the ligamenta flava
Michał Kłosiński1, Janusz Skrzat, Jerzy Walocha
1Department of Anatomy, Collegium Medicum, Jagiellonian University, Poland. mcklosinski@poczta.onet.pl
Abstract:
The ligamenta flava, together with the vertebral lamina, form the posterior wall of the spinal canal. Since they are located immediately adjacent to the nerve structures of the spinal cord, every pathology that involves hypertrophy produces neurological disturbances as a result. One of the most common reasons for hypertrophy of the ligamenta flava is heterotopic ossification. The main regions of the world where this disorder occurs are the Asian countries, especially Japan, but there are increasing numbers of such cases in other populations. The most important causes of the formation of ectopic osseous tissue in the vicinity of the ligamenta flava are thought to be mechanical stress and genetic predisposition. Treatment is mostly limited to surgical procedures. The present study is a review of the current state of our knowledge concerning the ossification of the ligamenta flava, the sequelae of this pathology, and the treatment methods.
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