Journal List > J Korean Soc Spine Surg > v.22(3) > 1076056

Nam, Cho, Yi, and Lee: Posterior Ring Apophysis Fracture Associated with Lumbar Disc Herniation Treated by Immobile Bony Fragment Excision - A Case Report -

Abstract

Study Design

A case report.

Objectives

We report a case of posterior ring apophysis fracture (PRAF) with lumbar disc herniation treated by immobile bony fragment excision.

Summary of Literature Review

PRAF causes severe radiculopathy, so treating with surgery is common.

Materials and Methods

A 30-year-old male diagnosed with PRAF with lumbar disc herniation was treated with discectomy, but his clinical symptoms were not relieved. Consequently, bony fragment excision, extended laminectomy and interbody fusion were also done.

Results

Radicular pain was relieved and showed good clinical outcome.

Conclusions

When treating PRAF, bony fragment excision and extended laminectomy should be considered even if an immobile bony fragment exists.

REFERENCES

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Fig. 1.
(A-B) A sagittal and axial T2 weighted MRI of L4-5 level shows herniated disc material and bony fragment (white arrow) located centrally and markedly occupying the spinal canal space. Bony defect (asterisk) was noted at the posterior endplate of L5.
jkss-22-118f1.tif
Fig. 2.
An intraoperative microscopic photo shows adequate decompression at the lateral recess to the foramen and mobilization of the left L5 root.
jkss-22-118f2.tif
Fig. 3.
(A-B) Postoperative MRI and CT show a decompressed left lateral recess.
jkss-22-118f3.tif
Fig. 4.
(A-B) After second operation, a sagittal and axial MRI shows adequate decompression was done at the L4-5 level.
jkss-22-118f4.tif
Fig. 5.
Postoperative views after three years, (A-B) The anteroposterior and lateral views of the plain radiograph show bony union.
jkss-22-118f5.tif
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