Anterior herniation of the nucleus pulposus: radiologic and clinical features

A prospective study disclosed eight patients (three children and five adults) with anterior herniation of the nucleus pulposus (AHNP); in five of the eight, AHNP was an incidental finding. Radiologic findings included erosion and/or fracture of the anterior aspect of the vertebra, usually with interspace narrowing. The complete blood count and erythrocyte sedimentation rate were normal in children with AHNP. A five-year clinical follow-up of six of the eight patients showed minimal morbidity in five; one patient had surgery with good results. AHNP is usually confused with fracture (old or acute) or infection; the correct radiologic diagnosis obviates the need for invasive diagnostic tests. Computerized tomography and nuclear magnetic resonance may prove to be useful in the diagnosis of AHNP.