Abstract
Lumbar disc herniation seldom occurs in the first decade of life. Degenerative alterations in the annulus fibrosus and nucleus pulposis occurs with advancing age, but not of significant magnitude until the third decade of life.
Dislocation of the bony epophyseal ring, or ring apophysis, has been reported frequently in adolescent cases.
We present a case of herniated lumbar intervertebral disc associated with dislocated ring apophysis in an 8-year-old boy.
The patient was admitted with acute lumbar pain associated with inability to bend forwarp and limping right after jumping over an obstacle. Physical examination showed tight hamstring on the right and positive Lasegue test at 10°.
Myelogram revealed a filling defect in the S1 root sleeve on the right. Partial laminectomy and removal of the fifth herniated intervertebral disc on the right side was performed. A large protruded disc, 6×8mm, was identified and removed. The histology showed cancellous bone and hyaline cartilage, plus acellular hyaline tissue consistent with intervertebral disc, which suggested dislocated apophyseal ring.
Postoperative course was benign.
