POSTERIOR LIMBUS VERTEBRAL LESIONS CAUSING LUMBOSACRAL RADICULOPATHY AND THE CAUDA-EQUINA SYNDROME

This report reviews our experience with spinal decompression for poste rior limbus vertebral lesions or osteocartilaginous vertebral corner d efects in the lumbar spine in 29 children and young adults. There were 19 male and 10 female patients with a mean age of 16.5 years (range, 9 to 24 years). Twenty-four patients were involved with various athlet ic activities. Clinical presentation included low back pain with a var iable degree of radiculopathy in 25 patients and a cauda equina syndro me in four. The level of the affected spinal area was L1-2 in one pati ent, L2-3 in one, L3-4 in seven, L4-5 in 17, and L5-S1 in three. The p reoperative imaging workup showed lateralised 'non-calcified' or 'calc ified' limbus vertebral defects in 13 patients and centrally displaced lesions in 16 patients. All patients underwent posterior spinal decom pression with a slightly extended laminotomy, except for three patient s who had a subsequent posterolateral fusion. All of the patients cons equently returned to practice their favourite preoperative sport and l ifestyle, but five discontinued their previous sports. We suggest that patients with posterior limbus vertebral lesions require careful diag nosis and therapy that are different from those with an ordinary lumba r disc herniation.