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Review
. 2014 Apr;12(2):230-1.
doi: 10.1590/s1679-45082014rc2736.

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

[Article in English, Portuguese]
José Alexandre Lopes da Silva Alvarenga  1 , Fernando Tadashi Salvioni Ueta  1 , David Del Curto  1 , Renato Hiroshi Salvioni Ueta  1 , Delio Eulalio Martins  1 , Marcelo Wajchenberg  1 , Eduardo Barros Puertas  1
Affiliations
Review

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

[Article in English, Portuguese]
José Alexandre Lopes da Silva Alvarenga et al. Einstein (Sao Paulo). 2014 Apr.

Abstract
in English, Portuguese

Apophyseal ring fractures are rare injuries that may be associated with lumbar disc herniation in young patients. We report a unique case in the literature of a 15-year-old male patient who played football and was admitted at our service complaining of sciatica radiating into the left leg. An apophysial ring injury of L5 vertebral body was observed. This injury caused two extruded disc herniation in adjacent levels. Surgical procedure was indicated after failure of conservative treatment.

As fraturas do anel apofisário são lesões raras, que podem estar associadas à hérnia de disco lombar nos pacientes jovens. Apresentamos aqui um caso único na literatura de paciente de 15 anos, gênero masculino, praticante de futebol, com queixa de ciatalgia para o membro inferior esquerdo. Houve lesão do anel apofisário, nos planaltos superior e inferior do corpo vertebral de L5, ocasionando hérnias discais extrusas nos níveis adjacentes. O procedimento cirúrgico foi indicado após a falha do tratamento conservador.

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Figures

Figure 1
Figure 1. (A) Posteroanterior radiographs of the lumbar sacral spine. (B) Lateral radiograph of lumbar sacral spine
Figure 2
Figure 2. (A and B) Computed tomography and axial slices showing the apophyseal ring fracture (arrow). C) Sagittal slice shows the double injury of apophyseal ring (arrows)
Figure 3
Figure 3. Magnetic resonance, sagittal slice, weighted in T2, showing two extruded herniated disks in levels L4-L5 and L5-S1
Figure 4
Figure 4. Disc material removed in the surgical procedure
See this image and copyright information in PMC

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