Abstract
Lumbar disc herniation in adolescents is a rare condition. It is commonly associated with fracture of the vertebral ring apophysis. The diagnosis is most clearly established by CT scan. The differential diagnosis is important and should include spine and spinal cord tumours, discitis and neuropathy. A case is presented to illustrate the pathophysiology, clinical and radiological diagnosis and to discuss the differential diagnosis.
Keywords: adolescent, disc herniation, ring apophysis, fracture diagnosis, chiropractic, manipulation
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- Dake M. D., Jacobs R. P., Margolin F. R. Computed tomography of posterior lumbar apophyseal ring fractures. J Comput Assist Tomogr. 1985 Jul-Aug;9(4):730–732. doi: 10.1097/00004728-198507010-00013. [DOI] [PubMed] [Google Scholar]
- Dietemann J. L., Runge M., Badoz A., Dosch J. C., Beaujeux R., Bonneville J. F., Wackenheim A. Radiology of posterior lumbar apophyseal ring fractures: report of 13 cases. Neuroradiology. 1988;30(4):337–344. doi: 10.1007/BF00328185. [DOI] [PubMed] [Google Scholar]
- Keller R. H. Traumatic displacement of the cartilagenous vertebral rim: a sign of intervertebral disc prolapse. Radiology. 1974 Jan;110(1):21–24. doi: 10.1148/110.1.21. [DOI] [PubMed] [Google Scholar]
- Lippitt A. B. Fracture of a vertebral body end plate and disk protrusion causing subarachnoid block in an adolescent. Clin Orthop Relat Res. 1976 May;(116):112–115. [PubMed] [Google Scholar]
- Lowrey J. J. Dislocated lumbar vertebral epiphysis in adolescent children. Report of three cases. J Neurosurg. 1973 Feb;38(2):232–234. doi: 10.3171/jns.1973.38.2.0232. [DOI] [PubMed] [Google Scholar]
- McCall I. W., Park W. M., O'Brien J. P., Seal V. Acute traumatic intraosseous disc herniation. Spine (Phila Pa 1976) 1985 Mar;10(2):134–137. doi: 10.1097/00007632-198503000-00004. [DOI] [PubMed] [Google Scholar]
- Nwuga V. C. Relative therapeutic efficacy of vertebral manipulation and conventional treatment in back pain management. Am J Phys Med. 1982 Dec;61(6):273–278. [PubMed] [Google Scholar]
- Pettersson H., Harwood-Nash D. C., Fitz C. R., Chuang S., Armstrong E. The CT appearance of avulsion of the posterior vertebral apophysis. A case report. Neuroradiology. 1981;21(3):145–147. doi: 10.1007/BF00339523. [DOI] [PubMed] [Google Scholar]
- Quon J. A., Cassidy J. D., O'Connor S. M., Kirkaldy-Willis W. H. Lumbar intervertebral disc herniation: treatment by rotational manipulation. J Manipulative Physiol Ther. 1989 Jun;12(3):220–227. [PubMed] [Google Scholar]
- Techakapuch S. Rupture of the lumbar cartilage plate into the spinal canal in an adolescent. A case report. J Bone Joint Surg Am. 1981 Mar;63(3):481–482. [PubMed] [Google Scholar]