The ligamentum flavum is the structure most prone to hypertrophy causing lumbar canal stenosis. It connects adjacent laminae. Hypertrophy of this structure causes neurogenic claudication by compressing the:

• A Anterior longitudinal ligament and vertebral bodies
• B Anterior nerve roots only
• C Cauda equina posteriorly within the spinal canal ✓
• D Conus medullaris at L1

Explanation

Hypertrophied ligamentum flavum encroaches on the posterior aspect of the lumbar spinal canal, compressing the cauda equina. This causes neurogenic claudication — bilateral leg pain, numbness, and weakness brought on by walking and relieved by sitting or leaning forward (flexion opens the canal). This distinguishes it from vascular claudication (relieved by rest without postural change). The conus medullaris ends at L1–L2, so lumbar canal stenosis below this level affects cauda equina, not the cord.

Reference: BD Chaurasia's Human Anatomy, 8th ed.

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Written and medically reviewed by the StethoPrep medical team.