Fracture of the vertebral limbus

An 18-year-old young man suffering from fracture of the limbus of L4 was admitted to the emergency ward after a car collision. Radiological evidence of the lesion was visible on plain film radiographs and CT scans. On surgery the posterior column was found to be intact. Treatment included a wide laminectomy, excision of the fragment, and osteosynthesis with Cotrel-Dubous-set instrumentation. The characteristics of these lesions are reviewed on the basis of the latest reports. The possibility of misreading these fractures is emphasized, especially in traumatic adult spine surgery.