고정된 골편 절제술로 치료한 요추 추간판 탈출증과 동반된 후방 연골단판 골절 - 증례 보고 - = Posterior Ring Apophysis Fracture Associated with Lumbar Disc Herniation Treated by Immobile Bony Fragment Excision - A Case Report -

다국어 초록 (Multilingual 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.

국문 초록 (Abstract)

연구 계획: 증례 보고적: 고정된 골편 절제술로 치료한 요추 추간판 탈출증과 동반된 연골단판 골절 1예를 보고하고자 한다.
선행 문헌의 요약: 후방 연골단판 골절은 심한 신경근 자극 증상을 일으켜 수술적 치료를 요하는 경우가 흔하다.
대상 및 방법: 요추 추간판 탈출증과 동반된 연골단판 골절을 진단받은 30세 남자에서 추간판 절제술을 하였으나 호전이 없어 골편 절제술, 광범위 후궁 절제술 및 추체간 유합술을 시행하였다.
결과: 술후 방사통이 호전되었으며 양호한 임상 결과를 얻었다.
결론: 연골단판 골절을 치료할 때 골편이 고정된 경우에도 골편 절제술 및 광범위 후궁 절제술을 고려해야 한다.

참고문헌 (Reference)

1 Beggs I, "Posterior vertebral rim fractures" 71 : 567-572, 1998

2 Akhaddar A, "Posterior ring apophysis separation combined with lumbar disc herniation in adults: a 10-year experience in the surgical management of 87 cases" 14 : 475-483, 2011

3 Yang IK, "Posterior lumbar apophyseal ring fractures: a report of 20 cases" 36 : 453-455, 1994

4 Savini R, "Posterior lumbar apophyseal fractures" 16 : 1118-1123, 1991

5 Epstein NE, "Lumbar surgery for 56 limbus fractures emphasizing noncalcified type III lesions" 17 : 1489-1496, 1992

6 Shirado O, "Lumbar disc herniation associated with separation of the ring apophysis:is removal of the detached apophyses mandatory to achieve satisfactory results?" (431) : 120-128, 2005

7 Asazuma T, "Lumbar disc herniation associated with separation of the posterior ring apophysis: analysis of five surgical cases and review of the literature" 145 : 461-466, 2003

8 Chang CH, "Clinical significance of ring apophysis fracture in adolescent lumbar disc herniation" 33 : 1750-1754, 2008

9 Banerian KG, "Association of vertebral end plate fracture with pediatric lumbar intervertebral disk herniation: value of CT and MR imaging" 177 : 763-765, 1990