Posterior lumbar apophyseal fractures.

From 1984 to 1987, nine patients with posterior lumbar apophyseal fracture underwent surgery. The clinical pattern was characterized by vertebral rigidity and leg pain in all cases, with associated nerve root deficit in three cases, neurogenic claudication in one, and paraparesis in one. In all patients, treatment consisted of removal of a bony and/or cartilaginous fragment. In eight patients, it was done through a posterior approach (unilateral laminotomy with partial facetectomy in six cases and bilateral laminectomy in two) and in one with paraparesis by means of hemicorporectomy followed by anterior fusion. At follow-up (minimum, 2 years), all patients showed complete regression of the painful symptoms, with a total recovery in cases with neurologic problems. The only complication was an incomplete cauda syndrome; this appeared immediately after the operation and regressed completely with conservative treatment after 6 months.