The supraspinous ligament (also supraspinal ligament) begins at the spinous process of the seventh vertebra (C7). It goes down in a caudal direction, crossing over all the spinous processes of the vertebrae till it ends at the median sacral crest of the sacrum at the level of S1; therefore, the ligament connects the apices of the spinous processes from the seventh vertebrae to the sacrum, although the thickest fibers of the ligament already end at the level of L3-L5.