Limbus Vertebra and Chronic Low Back Pain

Limbus vertebra is defined as the presence of an ossicle or an adjacent bone affecting the margin angle of the vertebral bodies. The characteristic appearance on plain films is a detached fragment with triangular morphology and sclerotic margins. It represents a marginal herniation of the nucleus pulposus during childhood or adolescence through the vertebral end-plate and beneath the apophyseal ring. Usually it is considered an incidental finding and an asymptomatic entity. However, several studies have suggested a significant relationship between the limbus vertebra and the low back pain (LBP), possibly due to an underlying intervertebral disc degeneration (IDD). In order to contribute to the debate, we present the case of an adult male who has a double limbus vertebra and suffers from chronic LBP.