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Spine
Diagnosis
Congenital and Genetic Disorders
Congenital
Normal Anatomical Variations
Limbus Vertebra
Limbus Vertebra
Kevin R. Moore, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Abbreviations

                • Limbus vertebra (LV)

              • Synonyms

                • Slipped vertebral apophysis

              • Definitions

                • Variation of vertebral cartilaginous node formation
                  • Intraosseous disc penetration at junction of cartilaginous endplate, developing rim apophysis (RA)

              IMAGING

              • General Features

                • Radiographic Findings

                  • CT Findings

                    • MR Findings

                      • Nonvascular Interventions

                        • Imaging Recommendations

                          DIFFERENTIAL DIAGNOSIS

                            PATHOLOGY

                            • General Features

                              • Gross Pathologic & Surgical Features

                                • Microscopic Features

                                  CLINICAL ISSUES

                                  • Presentation

                                    • Demographics

                                      • Natural History & Prognosis

                                        • Treatment

                                          DIAGNOSTIC CHECKLIST

                                          • Consider

                                            • Image Interpretation Pearls

                                              Selected References

                                              1. Carrasco Cubero C et al: Mechanical low back pain as a presentation of anterior limbus vertebra. Reumatol Clin. 13(3):176-7, 2017
                                              2. Zhang W et al: Limbus vertebra on bone scintigraphy in a pediatric patient. Clin Nucl Med. 40(11):915-6, 2015
                                              3. Mutlu V et al: Cervical limbus vertebra presenting as a hypopharyngeal mass. Spine J. 14(6):1079-80, 2014
                                              4. Yen Y et al: Giant limbus vertebra mimicking a vertebral fracture. QJM. 107(11):937-8, 2014
                                              5. Huang PY et al: Imaging features of posterior limbus vertebrae. Clin Imaging. 36(6):797-802, 2012
                                              6. Chang CH et al: Clinical significance of ring apophysis fracture in adolescent lumbar disc herniation. Spine (Phila Pa 1976). 33(16):1750-4, 2008
                                              7. Peoples RR et al: Whole-spine dynamic magnetic resonance study of contortionists: anatomy and pathology. J Neurosurg Spine. 8(6):501-9, 2008
                                              8. DePalma MJ et al: Nonspondylolytic etiologies of lumbar pain in the young athlete. Curr Sports Med Rep. 5(1):44-9, 2006
                                              9. Shirado O et al: Lumbar disc herniation associated with separation of the ring apophysis: is removal of the detached apophyses mandatory to achieve satisfactory results? Clin Orthop Relat Res. (431):120-8, 2005
                                              10. Chen LH et al: Intervertebral disc herniation in adolescents. Chang Gung Med J. 27(1):22-8, 2004
                                              11. 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
                                              12. Mendez JS et al: Limbus lumbar and sacral vertebral fractures. Neurol Res. 24(2):139-44, 2002
                                              13. Mupparapu M et al: Radiographic diagnosis of Limbus vertebra on a lateral cephalometric film: report of a case. Dentomaxillofac Radiol. 31(5):328-30, 2002
                                              14. 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
                                              15. Martinez-Lage JF et al: Avulsed lumbar vertebral rim plate in an adolescent: trauma or malformation? Childs Nerv Syst. 14(3):131-4, 1998
                                              16. 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
                                              17. Talha A et al: Fracture of the vertebral limbus. Eur Spine J. 6(5):347-50, 1997
                                              18. Henales V et al: Intervertebral disc herniations (limbus vertebrae) in pediatric patients: report of 15 cases. Pediatr Radiol. 23(8):608-10, 1993
                                              19. Cao LB et al: Imaging study of lumbar posterior marginal intraosseous node. An analysis of 36 cases. Chin Med J (Engl). 105(10):866-9, 1992
                                              20. Epstein NE: Lumbar surgery for 56 limbus fractures emphasizing noncalcified type III lesions. Spine. 17(12):1489-96, 1992
                                              21. Epstein NE et al: Limbus lumbar vertebral fractures in 27 adolescents and adults. Spine. 16(8):962-6, 1991
                                              22. Banerian KG et al: Association of vertebral end plate fracture with pediatric lumbar intervertebral disk herniation: value of CT and MR imaging. Radiology. 177(3):763-5, 1990
                                              23. Goldman AB et al: Posterior limbus vertebrae: a cause of radiating back pain in adolescents and young adults. Skeletal Radiol. 19(7):501-7, 1990
                                              24. Hsu K et al: High lumbar disc degeneration. Incidence and etiology. Spine. 15(7):679-82, 1990
                                              25. McCarron RF: A case of mistaken identity, limbus annulare mimics fracture. Orthop Rev. 16(3):173-5, 1987
                                              26. Kerns S et al: Annulus fibrosus calcification in the cervical spine: radiologic-pathologic correlation. Skeletal Radiol. 15(8):605-9, 1986
                                              27. Yagan R: CT diagnosis of limbus vertebra. J Comput Assist Tomogr. 8(1):149-51, 1984
                                              28. Kozlowski K: Anterior intervertebral disc herniations in children: unrecognised chronic trauma to the spine. Australas Radiol. 23(1):67-71, 1979
                                              29. Ghelman B et al: The limbus vertebra: an anterior disc herniation demonstrated by discography. Am J Roentgenol. 127(5):854-5, 1976
                                              30. Carreon LY et al: Neovascularization induced by anulus and its inhibition by cartilage endplate. Its role in disc absorption.
                                              Related Anatomy
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                                              Related Differential Diagnoses
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                                              References
                                              Tables

                                              Tables

                                              KEY FACTS

                                              • Terminology

                                                • Imaging

                                                  • Top Differential Diagnoses

                                                    • Pathology

                                                      • Clinical Issues

                                                        • Diagnostic Checklist

                                                          TERMINOLOGY

                                                          • Abbreviations

                                                            • Limbus vertebra (LV)

                                                          • Synonyms

                                                            • Slipped vertebral apophysis

                                                          • Definitions

                                                            • Variation of vertebral cartilaginous node formation
                                                              • Intraosseous disc penetration at junction of cartilaginous endplate, developing rim apophysis (RA)

                                                          IMAGING

                                                          • General Features

                                                            • Radiographic Findings

                                                              • CT Findings

                                                                • MR Findings

                                                                  • Nonvascular Interventions

                                                                    • Imaging Recommendations

                                                                      DIFFERENTIAL DIAGNOSIS

                                                                        PATHOLOGY

                                                                        • General Features

                                                                          • Gross Pathologic & Surgical Features

                                                                            • Microscopic Features

                                                                              CLINICAL ISSUES

                                                                              • Presentation

                                                                                • Demographics

                                                                                  • Natural History & Prognosis

                                                                                    • Treatment

                                                                                      DIAGNOSTIC CHECKLIST

                                                                                      • Consider

                                                                                        • Image Interpretation Pearls

                                                                                          Selected References

                                                                                          1. Carrasco Cubero C et al: Mechanical low back pain as a presentation of anterior limbus vertebra. Reumatol Clin. 13(3):176-7, 2017
                                                                                          2. Zhang W et al: Limbus vertebra on bone scintigraphy in a pediatric patient. Clin Nucl Med. 40(11):915-6, 2015
                                                                                          3. Mutlu V et al: Cervical limbus vertebra presenting as a hypopharyngeal mass. Spine J. 14(6):1079-80, 2014
                                                                                          4. Yen Y et al: Giant limbus vertebra mimicking a vertebral fracture. QJM. 107(11):937-8, 2014
                                                                                          5. Huang PY et al: Imaging features of posterior limbus vertebrae. Clin Imaging. 36(6):797-802, 2012
                                                                                          6. Chang CH et al: Clinical significance of ring apophysis fracture in adolescent lumbar disc herniation. Spine (Phila Pa 1976). 33(16):1750-4, 2008
                                                                                          7. Peoples RR et al: Whole-spine dynamic magnetic resonance study of contortionists: anatomy and pathology. J Neurosurg Spine. 8(6):501-9, 2008
                                                                                          8. DePalma MJ et al: Nonspondylolytic etiologies of lumbar pain in the young athlete. Curr Sports Med Rep. 5(1):44-9, 2006
                                                                                          9. Shirado O et al: Lumbar disc herniation associated with separation of the ring apophysis: is removal of the detached apophyses mandatory to achieve satisfactory results? Clin Orthop Relat Res. (431):120-8, 2005
                                                                                          10. Chen LH et al: Intervertebral disc herniation in adolescents. Chang Gung Med J. 27(1):22-8, 2004
                                                                                          11. 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
                                                                                          12. Mendez JS et al: Limbus lumbar and sacral vertebral fractures. Neurol Res. 24(2):139-44, 2002
                                                                                          13. Mupparapu M et al: Radiographic diagnosis of Limbus vertebra on a lateral cephalometric film: report of a case. Dentomaxillofac Radiol. 31(5):328-30, 2002
                                                                                          14. 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
                                                                                          15. Martinez-Lage JF et al: Avulsed lumbar vertebral rim plate in an adolescent: trauma or malformation? Childs Nerv Syst. 14(3):131-4, 1998
                                                                                          16. 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
                                                                                          17. Talha A et al: Fracture of the vertebral limbus. Eur Spine J. 6(5):347-50, 1997
                                                                                          18. Henales V et al: Intervertebral disc herniations (limbus vertebrae) in pediatric patients: report of 15 cases. Pediatr Radiol. 23(8):608-10, 1993
                                                                                          19. Cao LB et al: Imaging study of lumbar posterior marginal intraosseous node. An analysis of 36 cases. Chin Med J (Engl). 105(10):866-9, 1992
                                                                                          20. Epstein NE: Lumbar surgery for 56 limbus fractures emphasizing noncalcified type III lesions. Spine. 17(12):1489-96, 1992
                                                                                          21. Epstein NE et al: Limbus lumbar vertebral fractures in 27 adolescents and adults. Spine. 16(8):962-6, 1991
                                                                                          22. Banerian KG et al: Association of vertebral end plate fracture with pediatric lumbar intervertebral disk herniation: value of CT and MR imaging. Radiology. 177(3):763-5, 1990
                                                                                          23. Goldman AB et al: Posterior limbus vertebrae: a cause of radiating back pain in adolescents and young adults. Skeletal Radiol. 19(7):501-7, 1990
                                                                                          24. Hsu K et al: High lumbar disc degeneration. Incidence and etiology. Spine. 15(7):679-82, 1990
                                                                                          25. McCarron RF: A case of mistaken identity, limbus annulare mimics fracture. Orthop Rev. 16(3):173-5, 1987
                                                                                          26. Kerns S et al: Annulus fibrosus calcification in the cervical spine: radiologic-pathologic correlation. Skeletal Radiol. 15(8):605-9, 1986
                                                                                          27. Yagan R: CT diagnosis of limbus vertebra. J Comput Assist Tomogr. 8(1):149-51, 1984
                                                                                          28. Kozlowski K: Anterior intervertebral disc herniations in children: unrecognised chronic trauma to the spine. Australas Radiol. 23(1):67-71, 1979
                                                                                          29. Ghelman B et al: The limbus vertebra: an anterior disc herniation demonstrated by discography. Am J Roentgenol. 127(5):854-5, 1976
                                                                                          30. Carreon LY et al: Neovascularization induced by anulus and its inhibition by cartilage endplate. Its role in disc absorption.