Intervertebral disc herniations (limbus vertebrae) in pediatric patients: Report of 15 cases

Abstract

A revision of 15 cases of back pain and radiological features characteristic of anterior or posterior limbus vertebrae is presented. We comment on the radiological findings observed in the various imaging studies performed (conventional radiology, CT and MRI), which were attributed to the herniation of disc material into the vertebral body. In three patients who were followed up 12 years after the diagnosis, the initial roentgenograms of limbus vertebrae progressed in adult hood into radiological images characteristic of Schmorl's hernia as a sequela.

Lysis at the anterior vertebral body margin: evidence for brucellar spondylitis?

“…Continuity of disc material beneath the detached marginal fragment(s) has been demonstrated in cadaver preparations (Schmorl & Junghanns, 1971: Fig. 170), and in living patients by discography (Ghelman & Freiberger, 1976) and MRI (Hennales et al, 1993;Swischuk et al, 1998). Bone at the edges of the defect on the vertebral body becomes somewhat sclerotic due to remodelling of the lesion margins (Yagan, 1984;Hennales et al, 1993).…”

“…Taking an oblique course (Figure 4), the displaced disc material exits the anterior wall of the vertebral body, isolating one or more bone fragments at the antero-superior or anteroinferior margin (Schmorl & Junghanns, 1971: 169-72;Resnick & Niwayama, 1978;Yagan, 1984). In lateral radiographs, lesions are oblique bony defects, the surfaces of which appear smooth or slightly irregular (Schmorl & Junghanns, 1971: 169-72;Ghelman & Freiberger, 1976;Yagan, 1984;Hennales et al, 1993). Continuity of disc material beneath the detached marginal fragment(s) has been demonstrated in cadaver preparations (Schmorl & Junghanns, 1971: Fig.…”

“…Minor hypertrophic changes may occur, with bone being deposited on the anterior wall of the affected vertebral body adjacent to the lesion (Yagan, 1984). Sometimes lesions are identified in mature adults; these have been interpreted as due to trauma in childhood or adolescence which went unremarked at the time (Hennales et al, 1993). In general, lesions are found in the lumbar spine, and the anterosuperior corner of the vertebral body is more affected than the antero-inferior edge (Ghelman & Freiberger, 1976;Hennales et al, 1993).…”

“…170), and in living patients by discography (Ghelman & Freiberger, 1976) and MRI (Hennales et al, 1993;Swischuk et al, 1998). Bone at the edges of the defect on the vertebral body becomes somewhat sclerotic due to remodelling of the lesion margins (Yagan, 1984;Hennales et al, 1993). Minor hypertrophic changes may occur, with bone being deposited on the anterior wall of the affected vertebral body adjacent to the lesion (Yagan, 1984).…”

“…Sometimes lesions are identified in mature adults; these have been interpreted as due to trauma in childhood or adolescence which went unremarked at the time (Hennales et al, 1993). In general, lesions are found in the lumbar spine, and the anterosuperior corner of the vertebral body is more affected than the antero-inferior edge (Ghelman & Freiberger, 1976;Hennales et al, 1993). In follow-up studies, some have observed the marginal fragments to remain detached (Greene et al, 1985), whilst others have observed them to unite eventually with the main part of the vertebral body (Hennales et al, 1993).…”