- slipped vertebral apophysis usually occurs in lower lumbar spine;
- limbus vertebral frx occur when fusion between vertebral ring apophysis and central cartilage is incomplete or delayed;
- ring apophysis w/ adjacent disc is displaced into vertebral canal;
- apophysis remain suseptible to fragmentation in both adolescents and young adults;
- associated w/ heavy lifting and vigorous physical activities;
- sciatica is more common in avulsion fracture of the cephalic posterior vertebral body than in the caudal portion;
- pt typically has signs & symptoms of acute herniated disc;
- may show small bone frag (which represents edge of ring apophysis) w/ in spinal canal;
- limbus vertebral frxs are only rarely diagnosed on plain x-rays;
- CT Scan:
- dx is is best made w/ imaging studies or with myelography;
- Diff Dx: disc herniation
- conservative treatment is usually unsuccessful, & most pts require operative excision of the disc and ring apophysis;
- simple disc excision is not adequate;
- posterior vertebral body apophyseal avulsion frxs that cause sciatica should be removed
Fracture of the posterior margin of a lumbar vertebral body.
Fracture of the lumbar vertebral apophysis.
Limbus lumbar vertebral fractures in 27 adolescents and adults.
Avulsion of the cervical ring apophyses: acute and chronic appearance.
Radiology of posterior lumbar apophyseal ring fractures: report of 13 cases.