Ligamentum Flavum Hypertrophy Animal Models: Methodological Trade-offs and Future Directions

Long Chen¹Wanxia Zhang^2*Yu Zhang^3*Qin Gong^1*

• ¹Foshan Hospital of Traditional Chinese Medicine, Foshan, China
• ²The First Dongguan Affiliated Hospital of Guangdong Medical University, Dongguan, China
• ³Guangdong Second Traditional Chinese Medicine Hospital, Guangzhou, China

Ligamentum flavum hypertrophy (LFH) is a key pathological factor in lumbar spinal stenosis (LSS), characterized by abnormal collagen deposition, reduced elastin fibers, and degenerative changes such as calcification. LFH compresses the spinal cord and nerve roots, causing symptoms like low back pain, numbness, and intermittent claudication, and can lead to central spinal stenosis, significantly affecting quality of life. The pathophysiology of LFH involves extracellular matrix remodeling, inflammatory mediator release, and biomechanical stress, contributing to spinal canal narrowing and nerve root compression. Despite known risk factors like age, obesity, and mechanical load, the exact mechanisms remain unclear. Reliable animal models are essential for understanding LFH and developing therapeutic strategies. This paper compares four major LFH animal models—surgical, biomechanical, chemical induction, and hybrid models—evaluating their clinical relevance, technical feasibility, cost-effectiveness, and limitations. It also discusses recommendations for improving these models to enhance preclinical and clinical application.