What causes a limbus bone?
Common causes include degenerative conditions (osteoarthritis, ankylosing spondylitis, spinal stenosis, herniated disk, pinched nerve), back strains and sprains, spinal fractures, growths (tumors, cysts, bone spurs) and spondylolisthesis.
How do you repair limbus vertebrae?
Limbus vertebra is usually diasgnosed incidently and usually doesn't need treetment. Symptomatic patients are treated conservatively but if conservative treatment fails surgical treatment may be needed. Usually total laminectomy is necessery for sufficient excision of limbus fragment [2].
Is limbus vertebra rare?
Although Limbus vertebra is not an uncommon radiological finding in an adult, it is a rare finding in the child or adolescent. The most common site for the presence of Limbus vertebra is the mid-lumbar region and less commonly occurs in the mid cervical region.
How common is limbus vertebra?
The limbus vertebra is a rare condition poorly described in the medical literature. Marginal intrabody herniation of the nucleus pulposus resulting in the separation of a triangular bone fragment.
What does L5 limbus vertebra mean?
Limbus vertebra (LV) represents a marginal interosseous herniation of the nucleus pulposus, usually in the midlumbar region. It is generally diagnosed as an incidental radiological finding during investigation of a case presenting low back pain or lumbar radiculopathy symptomatology.
What is a limbus?
Medical Definition of limbus : a border distinguished by color or structure especially : the marginal region of the cornea of the eye by which it is continuous with the sclera.
What is limbus deformity?
A limbus vertebra is a bone tubercle formed by bone trauma on a vertebral body, bearing a radiographic similarity to a vertebral fracture. The anterior-superior corner of a single vertebra is the common site for this defect although it can also be seen at the inferior corner as well as the posterior or anterior margin.
Where is your L4 and L5 located?
0:225:37Spinal Cord Injuries L1, L2, L3, L4, & L5 Vertebrae Explained ... - YouTubeYouTubeStart of suggested clipEnd of suggested clipThe lumbar spine is located in the lower back below the cervical and thoracic sections of the spine.MoreThe lumbar spine is located in the lower back below the cervical and thoracic sections of the spine. It consists of five vertebrae. Known as l1 through l5 these lumbar vertebrae contain spinal cord
Where is L5 on the spine?
lumbar spineThe lowest vertebra in your lumbar spine is the L5. It's the bone that rests right above your sacral spine, and it's the most common region of the back to suffer a range of common ailments, from herniated discs to spondylolisthesis.
Is spondylolysis a fracture?
0:010:53Spondylolysis (Scotty Dog Fracture) - YouTubeYouTubeStart of suggested clipEnd of suggested clipSpondylolysis refers to a defect in the vertebral column. And it's usually talking specificallyMoreSpondylolysis refers to a defect in the vertebral column. And it's usually talking specifically about a defect in the pars interarticularis. This is colloquially known as the Scottie dog fracture or
Is lumbar a spondylosis?
What is lumbar spondylosis? Spondylosis is age-related change of the bones (vertebrae) and discs of the spine. These changes are often called degenerative disc disease and osteoarthritis. When this condition is in the lower back, it's called lumbar spondylosis.
How does a pars fracture happen?
A pars defect or spondylolysis is a stress fracture of the bones of the lower spine. These fractures typically occur due to overuse. They can be on one or both sides of the vertebrae. It is a common cause of low back pain in children and adolescents.
Where is L5 on the spine?
lumbar spineThe lowest vertebra in your lumbar spine is the L5. It's the bone that rests right above your sacral spine, and it's the most common region of the back to suffer a range of common ailments, from herniated discs to spondylolisthesis.
What is chronic Schmorl's nodes?
0:142:05My MRI Says "Schmorl's Node." What Does That Mean? - YouTubeYouTubeStart of suggested clipEnd of suggested clipMri so schmorl's node is a is a defect in the bony part of the vertebral. Body well that soundsMoreMri so schmorl's node is a is a defect in the bony part of the vertebral. Body well that sounds complicated and specific and morning. And it's actually fairly asymptomatic.
Is spondylolysis a fracture?
0:010:53Spondylolysis (Scotty Dog Fracture) - YouTubeYouTubeStart of suggested clipEnd of suggested clipSpondylolysis refers to a defect in the vertebral column. And it's usually talking specificallyMoreSpondylolysis refers to a defect in the vertebral column. And it's usually talking specifically about a defect in the pars interarticularis. This is colloquially known as the Scottie dog fracture or
What are Modic changes?
Modic changes (MC) are bone marrow lesions seen within a vertebral body on magnetic resonance imaging (MRI), suggestive of being associated with low back pain (LBP). Their presence in clients receiving physiotherapy for low back pain may be of significance when discussing prognosis and benefits of exercise therapy.
What is a limbus vertebra?
A limbus vertebra is a bone tubercle formed by bone trauma on a vertebral body, bearing a radiographic similarity to a vertebral fracture. The anterior-superior corner of a single vertebra is the common site for this defect although it can also be seen at the inferior corner as well as the posterior or anterior margin. Anatomically, it is assumed to be an intra-vertebral body herniation of the disc material occurring during adolescent growth spurt when the ring apophysis has not yet fused. It was first described by Schmorl in 1927 and later in detail by Leif Sward and Adad Baranto.
When does disc herniation occur?
Anatomically, it is assumed to be an intra-vertebral body herniation of the disc material occurring during adolescent growth spurt when the ring apophysis has not yet fused. It was first described by Schmorl in 1927 and later in detail by Leif Sward and Adad Baranto.
Is a limbus fracture a symptom?
Viewed in a lateral radiograph, it appears as a triangular shaped bone fragment, not unlike an anterior lip fracture, but with softer edges. Limbus vertebra is not always symptomatic, but severe cases may lead to more serious pathological conditions and chronic pain.
Presentation
Low back pain for several months. Incidental finding on the plain film.
Case Discussion
A limbus vertebra represents herniation of nucleus polposus through a defect in the anterior margin of the vertebral body endplate and beneath the ring apophysis.
What is the arrow in Figure 3?
Figure 3: Anteroposterior view of the lumbar spine of the patient showing no acute abnormalities (A). Lateral views of the lumbar spine of the patient; white arrows indicate a well-corticated triangular osseous focus at the anterosuperior aspect of the L5 vertebral body, seen on the lumbar spine flexion view (B) and extension view (C). This is most consistent with a limbus vertebra at L5.
What is a lumbus vertebra?
Limbus vertebra was first described by Christian Schmorl in 1927 as an intraosseous herniation of the nucleus pulposus through the ring apophy sis, either anteriorly or posteriorly, and is thought to be a consequence of injury to immature skeleton in a child or an adolescent [1]. Literature has qualified this finding as a normal variant of the spine [2-4]. Many patients with this condition are asymptomatic; however, it can cause both acute or chronic back pain symptoms [5-8] . Limbus vertebra is not well known by physicians and can be misdiagnosed as a fracture, discitis, Schmorl’s node or a tumor, resulting in further unnecessary and even invasive diagnostic procedures [6,9]. A helpful orthopedic maneuver to aid in diagnosis is the stork test for spondylosis, whereby the patient stands on one leg and performs lumbar extension. This is then repeated with the other leg. The test is positive if there is ipsilateral pain during extension, which indicates lumbar joint pathology such as spondylosis, spondylolisthesis, or a limbus vertebra [6-8].
Why is early recognition of limbus important?
Therefore, early recognition is crucial to potentially prevent an unnecessary cascade of increasing expenses related to time, effort, medications, and resources to find the diagnosis when conservative treatment is preferred.
When does the ring apophysis fuse?
The vertebral ring apophysis ossifies between six and 13 years of age and fuses with the vertebral body during skeletal maturation at around 18 years of age [14]. Before fusion of the physis occurs, herniation can arise at a weak point between the ring apophysis and the adjacent vertebral body, resulting in an anterior or posterior limbus vertebra [15]. This can often be visualized with radiographic imaging. Computed tomography is considered the best method for further examination for uncertain diagnoses [2].
What would have been an appropriate next step had spondylosis been noted on radiography?
A single-photon emission computerized tomography scan or magnetic resonance imaging would have been an appropriate next step had spondylosis been noted on radiography or had the patient not responded to conservative treatments [10-12].
Is a limbus vertebra a differential diagnosis?
Conclusions. Limbus vertebra is a condition that should be part of the differential diagnosis for uncomplicated lower back pain. Familiarity with this diagnosis may help primary care physicians reduce unnecessary radiologic testing and cost to the patient.
Is a limbus vertebra a fracture?
Limbus vertebra is not well known by physicians and can be misdiagnosed as a fracture, discitis, Schmorl’s node or a tumor, resulting in further unnecessary and even invasive diagnostic procedures [6,9].
What is LV in a disc?
LV displays a primary pathology of the intervertebral disc, occurring as a result of herniation of the nucleus pulposus into the adjacent vertebral body .
What is LV in vertebral disc?
LV displays a primary pathology of the intervertebral disc, occurring as a result of herniation of the nucleus pulposus into the adjacent vertebral body. When this process takes place during childhood and adolescence before ossification happens, the extruded disc material disrupts the endplate, warding off the ring apophysis from the vertebral body [3]. This condition was described for the first time by C.G. Schmorl in 1927 though its prevalence remains unknown [4]. LV can affect the anterior or posterior column of the cervical and lumbar spine, with the anterorsuperior margin of a single vertebral body of the midlumbar spine being the most common site of manifestation [5].
What is LV in medical terms?
Limbus vertebra (LV) is a condition characterized by marginal interosseous herniation of nucleus pulposus causing non-specific symptoms such as back pain, local muscle spasm and radiculopathy. It is frequently confused with vertebral fracture, infection, Schmorl nodule or tumor since it does not present any specific symptoms [1].
What is LV in a sclerotic film?
Limbus vertebra (LV) is a condition characterized by marginal interosseous herniation of nucleus pulposus causing non-specific symptoms such as back pain, local muscle spasm and radiculopathy. It is frequently confused with vertebral fracture, infection, Schmorl nodule or tumor since it does not present any specific symptoms [1]. The characteristic appearance on plain films is represented as a detached fragment with triangular morphology and sclerotic margins, usually on the anterosuperior vertebral body corner. It represents a marginal herniation of the nucleus pulposus during childhood or adolescence through the vertebral endplate and beneath the apophyseal ring [2,3].
Where is the triangular bony fragment on a radiograph?
On plain radiographs (Figure 1 ), a triangular bony fragment with sclerotic margins was demonstrated on the anterosuperior corner of the third lumbar vertebra.
Is LV a radiographic condition?
Despite LV being described almost a century ago demonstrating clear radiographic findings, the condition remains widely unknown to the medical community making the definite diagnosis challenging. A physician should include the LV variant in the differential diagnosis of an anterosuperior triangular well-corticated fragment of a vertebra in the midlumbar region in order to achieve a more immediate diagnosis and avoid inessential diagnostic procedures.
