Neuraxial needle ligament sequence — FRCA Primary MCQ

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HardAnatomyNeuraxial needle ligament sequenceFRCA Primary

During midline lumbar epidural insertion, which ligament is traversed immediately before entering the epidural space?

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Correct answer: E — Ligamentum flavum

The best answer is “Ligamentum flavum”. The ligamentum flavum forms the posterior boundary of the epidural space. In a midline approach, the needle crosses supraspinous and interspinous ligaments before the ligamentum flavum, where increased resistance is commonly felt before loss of resistance into the epidural space.

Reference: RCoA, Primary FRCA Syllabus: https://rcoa.ac.uk/sites/default/files/documents/2026-01/Primary-FRCA-Syllabus.pdf