젊은 성인층에서 요추체 윤상 골단 골절의 임상적 분석 = Clinical Analysis of Posterior Lumbar Apophyseal Ring Fractures in Young Adults

다국어 초록 (Multilingual Abstract)

Lumbar apophyseal ring fracture occurs between the vertebral ring apophyses and the cartilaginous rim of the superior or inferior margins of the vertebral end plates. This fracture is an unusual disease that is typically seen in adolescents or young adults. We analyzed the clinical records and neuroradiologic imagings of 49 patients who were less than 29 years old diagnosed with posterior lumbar apophyseal ring fractures in regards to the age. trauma history, the type and distribution of the fracture, clinical presentation, and postoperative outcome. The posterior lumbar apophyseal ring fractures were detected in 49(9.2％) out of 533 young adult patients with herniated lumbar discs. There was trauma history in 37(75.5％) out of the 49 patients. The main presenting symptoms in most of the patients were low back pain and radiating leg pain. In patients who presented with symptoms. thirty-five patients(75.5％) had a positive straight leg-raising test. According to classification by Takata, they were type Ⅰ in 12 cases(24.0％), type Ⅱ in 9 cases(18.0％), and type Ⅲ in 29 cases(58.0％). The type Ⅲ with trauma history was more common than with non-trauma history(p<0.01). Twenty-one patients(42.0％) had bony fragments projecting into the spinal canal from the upper border of S1. Partial hemilaminectomy(18 patients) and total laminectomy(3 patients) were performed. We could easily remove the bony fragments in all of the surgical cases. Chemonucleolysis were done in three patients. The overall results were good.
Were conclude that knowledge of this entity and correct radiographic diagnosis will help to facilitate the operative planning.