====== Posterior Ligamentous Complex (PLC) Integrity ====== **Definition:** The **Posterior Ligamentous Complex (PLC)** refers to a group of ligaments and soft tissues that stabilize the **posterior aspect of the spinal column**. **PLC integrity** is critical for maintaining **spinal stability**, especially after trauma. **Components of the PLC:** * **Supraspinous ligament** * **Interspinous ligament** * **Ligamentum flavum** * **Facet joint capsules** **Function:** * Provides **posterior tension band** support to resist flexion, rotation, and shear forces. * Helps maintain alignment of the vertebrae. * Prevents **instability** and **progressive deformity** after spinal trauma. **Clinical Significance:** * Loss of PLC integrity is a key criterion in the **Thoracolumbar Injury Classification and Severity Score (TLICS)**. * MRI is the gold standard for assessing PLC injury. * Disruption may necessitate **surgical stabilization** even in the absence of neurological deficits or vertebral collapse. **Imaging Findings Suggestive of PLC Injury:** * Increased interspinous distance on X-ray or CT. * High signal in ligaments on T2/STIR MRI. * Facet dislocation or widening. * Kyphotic angulation. **Related Concepts:** * **Spinal instability** * **Thoracolumbar burst fractures** * **Flexion-distraction injuries**