Fx or avulsion of vertebral ring apophysis (RA) following injury in immature skeleton
Fx of anterior ring termed limbus vertebra
Fx of posterior ring termed posterior apophyseal ring Fx (PAR-Fx)
IMAGING
General Features
Radiographic Findings
CT Findings
MR Findings
Nonvascular Interventions
Nuclear Medicine Findings
Other Modality Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Staging, Grading, & Classification
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Image Interpretation Pearls
Selected References
Kadam G et al: Traumatic lumbar vertebral ring apophysis fracture with disk herniation in an adolescent. Radiol Case Rep. 12(2):427-30, 2017
Singhal A et al: Ring apophysis fracture in pediatric lumbar disc herniation: a common entity. Pediatr Neurosurg. 49(1):16-20, 2013
Wu X et al: A review of current treatment of lumbar posterior ring apophysis fracture with lumbar disc herniation. Eur Spine J. 22(3):475-88, 2013
Wu XY et al: Posterior lumbar ring apophysis fracture. Orthop Surg. 3(1):72-7, 2011
Chang CH et al: Clinical significance of ring apophysis fracture in adolescent lumbar disc herniation. Spine (Phila Pa 1976). 33(16):1750-4, 2008
Sairyo K et al: Three-dimensional finite element analysis of the pediatric lumbar spine. Part I: pathomechanism of apophyseal bony ring fracture. Eur Spine J. 15(6):923-9, 2006
Asazuma T et al: Lumbar disc herniation associated with separation of the posterior ring apophysis: analysis of five surgical cases and review of the literature. Acta Neurochir (Wien). 145(6):461-6; discussion 466, 2003
Mendez JS et al: Limbus lumbar and sacral vertebral fractures. Neurol Res. 24(2):139-44, 2002
Bonic EE et al: Posterior limbus fractures: five case reports and a review of selected published cases. J Manipulative Physiol Ther. 21(4):281-7, 1998
Martinez-Lage JF et al: Avulsed lumbar vertebral rim plate in an adolescent: trauma or malformation? Childs Nerv Syst. 14(3):131-4, 1998
Swischuk LE et al: Disk degenerative disease in childhood: Scheuermann's disease, Schmorl's nodes, and the limbus vertebra: MRI findings in 12 patients. Pediatr Radiol. 28(5):334-8, 1998
Talha A et al: Fracture of the vertebral limbus. Eur Spine J. 6(5):347-50, 1997
Fx or avulsion of vertebral ring apophysis (RA) following injury in immature skeleton
Fx of anterior ring termed limbus vertebra
Fx of posterior ring termed posterior apophyseal ring Fx (PAR-Fx)
IMAGING
General Features
Radiographic Findings
CT Findings
MR Findings
Nonvascular Interventions
Nuclear Medicine Findings
Other Modality Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Staging, Grading, & Classification
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Image Interpretation Pearls
Selected References
Kadam G et al: Traumatic lumbar vertebral ring apophysis fracture with disk herniation in an adolescent. Radiol Case Rep. 12(2):427-30, 2017
Singhal A et al: Ring apophysis fracture in pediatric lumbar disc herniation: a common entity. Pediatr Neurosurg. 49(1):16-20, 2013
Wu X et al: A review of current treatment of lumbar posterior ring apophysis fracture with lumbar disc herniation. Eur Spine J. 22(3):475-88, 2013
Wu XY et al: Posterior lumbar ring apophysis fracture. Orthop Surg. 3(1):72-7, 2011
Chang CH et al: Clinical significance of ring apophysis fracture in adolescent lumbar disc herniation. Spine (Phila Pa 1976). 33(16):1750-4, 2008
Sairyo K et al: Three-dimensional finite element analysis of the pediatric lumbar spine. Part I: pathomechanism of apophyseal bony ring fracture. Eur Spine J. 15(6):923-9, 2006
Asazuma T et al: Lumbar disc herniation associated with separation of the posterior ring apophysis: analysis of five surgical cases and review of the literature. Acta Neurochir (Wien). 145(6):461-6; discussion 466, 2003
Mendez JS et al: Limbus lumbar and sacral vertebral fractures. Neurol Res. 24(2):139-44, 2002
Bonic EE et al: Posterior limbus fractures: five case reports and a review of selected published cases. J Manipulative Physiol Ther. 21(4):281-7, 1998
Martinez-Lage JF et al: Avulsed lumbar vertebral rim plate in an adolescent: trauma or malformation? Childs Nerv Syst. 14(3):131-4, 1998
Swischuk LE et al: Disk degenerative disease in childhood: Scheuermann's disease, Schmorl's nodes, and the limbus vertebra: MRI findings in 12 patients. Pediatr Radiol. 28(5):334-8, 1998
Talha A et al: Fracture of the vertebral limbus. Eur Spine J. 6(5):347-50, 1997
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