Posterior Ring Apophysis Separation (PRAS): A relatively rare clinical entity in adolescents & young adults
Journal Title: Nepal Journal of Neuroscience - Year 2014, Vol 11, Issue 1
Abstract
Herniated Lumbar Disc (HLD) may be associated with separation of the posterior ring apophysis of the adjacent vertebral body. It is often diffi cult to diagnose radiologically and may be confused with calcifi cation of the posterior vertebral structures. We report a 32 years old male, presenting with a history of low back pain radiating to the left lower limb and associated with tingling sensation and paresthesia. Magnetic Resonance Imaging (MRI) of lumbosacral (LS) spine revealed left L5-S1 lateral disc herniation compressing the exiting nerve root. CT scan with sagittal reconstruction of LS spine revealed PRAS of upper lip of S1 vertebra. L5 partial laminectomy and microdiscectomy with removal of the loose bony fragment was done. Post-operative MRI demonstrated decompression of the spinal canal and the neural foramen. We report this case to familiarize the clinicians with this clinical entity as it requires strong clinical suspicion coupled with sagittal reconstruction CT scan for diagnosis and extensive exposure with removal of loose fragments together with discectomy for adequate relief of the symptoms.
Authors and Affiliations
Manish Kolakshyapati
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