Pathomechanism of Ligamentum Flavum Hypertrophy: A Multidisciplinary Investigation Based on Clinical, Biomechanical, Histologic, and Biologic Assessments

Abstract

Fibrosis is the main cause of ligamentum flavum hypertrophy, and fibrosis is caused by the accumulation of mechanical stress with the aging process, especially along the dorsal aspect of the ligamentum flavum. TGF-beta released by the endothelial cells may stimulate fibrosis, especially during the early phase of hypertrophy.