Aging, vertebral density, and disc degeneration alter the tensile stress‐strain characteristics of the human anterior longitudinal ligament

The mechanical properties of the human lumbar anterior longitudinal ligament were investigated, and the influence of aging, disc degeneration, and vertebral bone density on these properties was determined. Tensile mechanical properties of the vertebra‐anterior longitudinal ligament‐vertebra complex were determined for 16 segments from cadavera of individuals who had been 21–79 years old (mean, 52.1 years) at the time of death. Regional strain patterns associated with three sites across the width and three sites along the length of the anterior longitudinal ligament were measured with use of a video‐based motion analysis system. In the young, normal anterior longitudinal ligament, the elastic moduli of the insertion and substance regions of the ligament were similar (approximately 500 MPa). During aging (21–79 years), the elastic modulus of the substance region increased 2‐fold, whereas the elastic modulus of the insertion decreased 3‐fold; this resulted in an approximately 5‐fold difference in elastic modulus between these regions in the older spine. The strength of the bone‐ligament complex decreased approximately 2‐fold (from 29 to 13 MPa) over this same age range. The outer portion of the anterior longitudinal ligament consistently had the highest peak tensile strains (11.8 ± 2.7%) in all of the specimens examined. Preparations with nondegenerated discs and high bone density were significantly stronger (66%) and failed in the ligament substance; in contrast, segments from older individuals with degenerated discs and lower bone density failed in the ligament insertion regions.