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ANOMALIES AND FRACTURES OF THE VERTEBRAL ARTICULAR PROCESSES

WILBUR BAILEY, M.D.
[+] Author Affiliations

Read before the Section on Radiology, at the Eighty-Seventh Annual Session of the American Medical Association, Kansas City, Mo., May 14, 1936.


LOS ANGELES

From the Department of Radiology, University of Southern California School of Medicine.


JAMA. 1937;108(4):266-270. doi:10.1001/jama.1937.02780040016004
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Fissures across the vertebral articular processes may be formed by the presence of an ununited accessory center of ossification opposite the tips of the articular processes, or they may be the result of fracture of the articular processes. The differentiation between these anomalies and isolated fractures of the vertebral articular processes can nearly always be made, but even in the literature considerable confusion exists in making the distinction, and anomalies have been mistaken for fractures. If proper value is given to the history of the injury and to the appearance in the roentgenograms, such mistakes are preventable.

ANOMALIES  Much more common than fractures are the fissures due to anomalies which arise because of an accessory center of ossification opposite the tip of an articular process in the lumbar region. Such fissures are usually transverse, well demarcated and often bilateral or multiple. There are, however, variations which are shown in

REFERENCES

Müller, Walther:  Spaltbildungen an Gelenk und Dornfortsatzen der Wirbelsäule auf der Basis von Umbauzonen , Fortschr. a. d. Geb. d. Röntgenstrahlen 44:644-648 ( (Nov.) ) 1931;.
Grashey, R.:  Discussion at 22d Kongress der Deutschen Roentgen-Gesellschaft , Fortschr. a. d. Geb. d. Röntgenstrahlen 44, preliminary page 47 ( (Aug.) ) 1931;.
Meyer, M., and Forster, E.:  Arrêts de développement d'une vertèbre lombaire pouvant prèter à confusion avec une fracture vertébrale , Scalpel 86:1344-1347 ( (Sept. 2) ) 1933;.
Mardersteig, K.: Fortschr. a. d. Geb. d. Röntgenstrahlen 46: 441-449 ( (Oct.) ) 1932;.
Reisner A.:  Unterscheidungsmerkmale normaler, entzündlicher und posttraumatischer Zustände an der Wirbelsäule , Fortschr. a. d. Geb. d. Roentgenstrahlen 44: 726-751 ( (Dec.) ) 1931;.
Rendich, R. A., and Westing, S. W.:  Accessory Articular Process of Lumbar Vertebrae: Differentiation from Fracture , Am. J. Roentgenol. 29:156-160 ( (Feb.) ) 1933;.
Nichols, B. H., and Shiflett, E. L.:  Ununited Anomalous Epiphyses of the Inferior Articular Processes of the Lumbar Vertebrae , J. Bone & Joint Surg. 15:591-600 ( (July) ) 1933;.
Fulton, W. S., and Kalbfieisch, W. K.:  Accessory Processes of Lumbar Vertebrae , Arch. Surg. 29:42-48 ( (July) ) 1934;.
Mitchell, C. L.:  Isolated Fractures of Articular Processes of Lumbar Vertebrae , J. Bone & Joint Surg. 15:608-614 ( (July) ) 1933;.
Koch, K.:  Die isolierten Gelenkfortsatzbrüche an der Lendenwirbelsäule , Deutsche Ztschr. f. Chir. 180:339-355, 1923;.
Dohan, N.:  Roentgenbefunde bei Lumbago traumatica , Wien. med. Wchnschr. 60:976-982, 1910;.
Graessner:  Der roentgenologische Nachweis von Verletzungen der Wirbelsäule , Med. Klin. 8:1699-1702, 1912;.
Lippens, A., and Dejardin, L.:  La fracture des apophyses articulaires vertébrales , Bruxellés-méd. 12:732:734 ( (May 1) ) 1932;.
Burk, W.:  Ueber einen Bruch des Gelenkfortsatzes des V Lenden wirbels , Beitr. z. klin. Chir. 58:558-569, 1908;.
Litten, F.:  Ueber Spaltbildungen an den Gelenkfortsatzen der Wirbelsäule , Röntgenpraxis 4: 1039-1043 ( (Dec.) ) 1922;.

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Müller, Walther:  Spaltbildungen an Gelenk und Dornfortsatzen der Wirbelsäule auf der Basis von Umbauzonen , Fortschr. a. d. Geb. d. Röntgenstrahlen 44:644-648 ( (Nov.) ) 1931;.
Grashey, R.:  Discussion at 22d Kongress der Deutschen Roentgen-Gesellschaft , Fortschr. a. d. Geb. d. Röntgenstrahlen 44, preliminary page 47 ( (Aug.) ) 1931;.
Meyer, M., and Forster, E.:  Arrêts de développement d'une vertèbre lombaire pouvant prèter à confusion avec une fracture vertébrale , Scalpel 86:1344-1347 ( (Sept. 2) ) 1933;.
Mardersteig, K.: Fortschr. a. d. Geb. d. Röntgenstrahlen 46: 441-449 ( (Oct.) ) 1932;.
Reisner A.:  Unterscheidungsmerkmale normaler, entzündlicher und posttraumatischer Zustände an der Wirbelsäule , Fortschr. a. d. Geb. d. Roentgenstrahlen 44: 726-751 ( (Dec.) ) 1931;.
Rendich, R. A., and Westing, S. W.:  Accessory Articular Process of Lumbar Vertebrae: Differentiation from Fracture , Am. J. Roentgenol. 29:156-160 ( (Feb.) ) 1933;.
Nichols, B. H., and Shiflett, E. L.:  Ununited Anomalous Epiphyses of the Inferior Articular Processes of the Lumbar Vertebrae , J. Bone & Joint Surg. 15:591-600 ( (July) ) 1933;.
Fulton, W. S., and Kalbfieisch, W. K.:  Accessory Processes of Lumbar Vertebrae , Arch. Surg. 29:42-48 ( (July) ) 1934;.
Mitchell, C. L.:  Isolated Fractures of Articular Processes of Lumbar Vertebrae , J. Bone & Joint Surg. 15:608-614 ( (July) ) 1933;.
Koch, K.:  Die isolierten Gelenkfortsatzbrüche an der Lendenwirbelsäule , Deutsche Ztschr. f. Chir. 180:339-355, 1923;.
Dohan, N.:  Roentgenbefunde bei Lumbago traumatica , Wien. med. Wchnschr. 60:976-982, 1910;.
Graessner:  Der roentgenologische Nachweis von Verletzungen der Wirbelsäule , Med. Klin. 8:1699-1702, 1912;.
Lippens, A., and Dejardin, L.:  La fracture des apophyses articulaires vertébrales , Bruxellés-méd. 12:732:734 ( (May 1) ) 1932;.
Burk, W.:  Ueber einen Bruch des Gelenkfortsatzes des V Lenden wirbels , Beitr. z. klin. Chir. 58:558-569, 1908;.
Litten, F.:  Ueber Spaltbildungen an den Gelenkfortsatzen der Wirbelsäule , Röntgenpraxis 4: 1039-1043 ( (Dec.) ) 1922;.
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