Ten patients who underwent operation for compression of spinal nerve roots by the ligamentum flavum were followed for five years. Seven patients were completely cured, and definite improvement resulted in three. Diagnosis was made on the basis of duration (5 to 25 years' back pain) and evidence of root compression. Myelography revealed a large posterior indentation under the neural arch resulting in a partial or complete block. The ligamentum flavum seems to be the major cause of root compression in a limited number of patients. The surgical therapy recommended is a total laminectomy with wide resection of the ligamentum flavum and complete disk removal when indicated.
Beamer YB, Garner JT, Shelden CH. Hypertrophied Ligamentum FlavumClinical and Surgical Significance. Arch Surg. 1973;106(3):289-292. doi:10.1001/archsurg.1973.01350150029008