Apophyseal ring fracture associated with two levels extruded disc herniation: case report and review of the literature

Alvarenga, José Alexandre Lopes da Silva; Ueta, Fernando Tadashi Salvioni; Curto, David Del; Ueta, Renato Hiroshi Salvioni; Martins, Délio Eulálio; Wajchenberg, Marcelo; Puertas, Eduardo Barros

doi:10.1590/s1679-45082014rc2736

Cited by 8 publications

(6 citation statements)

References 16 publications

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“…Fracture of the vertebral ring apophysis is an uncommon but important cause of back pain in adolescents [1] . It usually follows a strenuous physical activity or trauma.…”

Section: Discussionmentioning

confidence: 99%

“…The annulus fibrosus is adhered to the superior and inferior vertebral plateau via the Sharpey's fibers and also to some fibers of the posterior longitudinal ligament. For these reasons, the fractures are commonly seen along the posterior aspect and in the midline [1] , [2] .…”

Section: Discussionmentioning

confidence: 99%

“…The purpose of this article is to draw attention to an unusual and extremely rare cause of back pain in adolescents and young adults, especially in athletes [1] , [2] , [3] , [4] . The common cause of back pain in this population is related to musculoskeletal injuries.…”

Section: Introductionmentioning

confidence: 99%

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Traumatic lumbar vertebral ring apophysis fracture with disk herniation in an adolescent

Kadam

Narsinghpura

Deshmukh

et al. 2017

Radiology Case Reports

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We present a case of a 15-year-old male with history of back pain and bilateral lower limb radiculopathy due to fall. The magnetic resonance imaging scan showed disc bulge at L2-L3 level causing compression on contained nerve roots. In this case, computed tomography scan was indispensable for diagnosis and classification of the vertebral apophyseal fracture and to guide appropriate further management. Apophyseal ring fracture is an uncommon cause of back pain with radiculopathy in adolescents and athletes. High degree of suspicion is necessary to differentiate these injuries from disc herniation so as to further guide appropriate conservative or surgical management. The common cause of back pain in this population is related to musculoskeletal injuries. Lumbar disc herniation contributes to negligible number of cases in this age group, as against that seen in the adult population. An important and rare etiology to be considered for these patients includes vertebral ring apophyseal fracture.

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“…Fracture of the vertebral ring apophysis is an uncommon but important cause of back pain in adolescents [1] . It usually follows a strenuous physical activity or trauma.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Traumatic lumbar vertebral ring apophysis fracture with disk herniation in an adolescent

Kadam

Narsinghpura

Deshmukh

et al. 2017

Radiology Case Reports

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show abstract

“… 9 Apophyseal ring fractures are rare injuries that mimic common disc herniation (though sometimes they may accompany it). 10 …”

Section: Discussionmentioning

confidence: 99%

Radiological Diagnosis of Chronic Back Pain

Jain¹,

Doki²,

Biswas³

et al. 2022

Oman Med J

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“…Low force osteoporotic traumatic fractures rarely present initially with either radicular symptoms or CES but can develop these symptoms as a result of progressive kyphotic deformity and gradual stenosis of the canal in the fractured area [7]. However, forceful traumatic fractures with bone deformation and displacement of the apophyseal ring and endplate with disc extrusion can lead to spinal cord injury and conus or cauda equina injury [8]. This is an unusual case, with a clinical history that retrospectively revealed the patient was in the early stages of the development of CES from an unsuspected intraspinal tumor.…”

Section: Introductionmentioning

confidence: 99%

Cauda Equina Syndrome in a Patient with Intradural Schwannoma at the Same Level as an Acute L2 Compression Fracture

Mallol¹,

Taveras²,

Hartman

et al. 2019

Cureus

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Intradural tumors are found often as either incidental findings or during evaluation during magnetic resonance imaging (MRI) for lumbar and/or radicular pain. This patient presented with an acute L2 compression fracture, however, the initial MRI identified a large spinal mass separate from the fracture but at the same level. The patient had acute upper lumbar pain after a fall but the neurologic examination also revealed findings of early cauda equina syndrome with muscle weakness, asymmetric leg numbness, and urinary incontinence. Further history revealed the patient had been using a cane for several months and having difficulty walking with some upper lumbar pain but had not seen a physician. The differential was an extruded disc associated with the fractured endplate versus a tumor. Because of the neurologic symptoms, emergency open decompression combined with multilevel screw fixation was performed. At the time of the laminectomy, the dura bulged posteriorly, no ventral disc was found, and a 3-cm intradural schwannoma was successfully excised with rapid neurologic recovery. The article will review the relationship of cauda equina syndrome with osteoporotic fractures and the rarity of actual true disc extrusion with compression fractures, as well as the more common relationship of finding cauda equina syndrome with intradural tumors when there is severe canal stenosis as seen in this unusual case.

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Apophyseal ring fracture associated with two levels extruded disc herniation: case report and review of the literature

Cited by 8 publications

References 16 publications

Traumatic lumbar vertebral ring apophysis fracture with disk herniation in an adolescent

Traumatic lumbar vertebral ring apophysis fracture with disk herniation in an adolescent

Radiological Diagnosis of Chronic Back Pain

Cauda Equina Syndrome in a Patient with Intradural Schwannoma at the Same Level as an Acute L2 Compression Fracture

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