Dietemann J L, Runge M, Badoz A, Dosch J C, Beaujeux R, Bonneville J F, Wackenheim A
Service de Radiologie, Hôpital Central, Strasbourg, France.
Neuroradiology. 1988;30(4):337-44. doi: 10.1007/BF00328185.
The authors report radiological findings in 13 cases of avulsion of the posterior lumbar apophyseal ring. The lesion affected young adults in 10 cases and adolescents in 3 cases. The lesion involved the inferior endplate of L4 in 11, and of L5 in 1 patient, and of L3 in 1 patient. 6 patients presented with unilateral sciatica, 3 with bilateral sciatica, and 4 with low back pain. Acute spinal trauma was evident only in 2 adolescents. Radiological recognition of the lesion was possible on plain films in 9 cases. CT demonstrates association of avulsion of the posterior vertebral apophyseal ring and herniated disc in all cases. Avulsion of the posterior apophyseal ring has to be differentiated from posterior longitudinal ligament, annulus, or herniated disc calcifications, as well as from posterior degenerative ridge osteophytes. Controversy about physiopathology of the lesion remains: weakness of the apophyseal ring during childhood and in patients with Scheuermann's disease may explain avulsion of the apophyseal ring in association with median disc herniation.
作者报告了13例腰椎后突环撕脱伤的影像学表现。10例患者为青壮年，3例为青少年。11例累及L4下终板，1例累及L5下终板，1例累及L3下终板。6例患者表现为单侧坐骨神经痛，3例为双侧坐骨神经痛，4例为腰痛。仅2例青少年有明显的急性脊柱外伤。9例患者通过X线平片可明确诊断。所有病例CT均显示椎体后突环撕脱与椎间盘突出并存。椎体后突环撕脱需与后纵韧带、椎间盘环或椎间盘突出钙化以及椎体后缘退变骨赘相鉴别。关于该损伤的病理生理学仍存在争议：儿童期及休门氏病患者的突环薄弱可能解释突环撕脱合并椎间盘正中突出的原因。
