Other congenital skeletal anomalies, such as, spina bifida occulta, sacralization of the fifth lumbar vertebra may accompany congenital bone bridges but these findings are not obligatory 6). On the other hand, osseous bridges of a congenital-developmental etiology are 'O' shaped with symmetrical, contour with convexity of the lumbar spine on the contralateral side and the absence of degenerative changes in the corresponding intervertebral space. The localizations of hematoma and myositis ossificans play important roles during bony bridge modeling, and the configurations and shapes of traumatic osseous transverse process bridges show acute angles and irregular, asymmetric outlines. In addition, criteria were suggested for the differentiation of congenital and traumatic osseous bridges. In this study, the youngest patient treated was 23 year old, but the origin of the osseous bridge was not obvious. 1) also found that only 15% of their cases had a congenital etiology. 7), in their review of lumbar osseous bridging in the literature, found that an association exists with back injury and that pseudarthrosis may form in heterotopic bone. Osseous bridging between two transverse processes of the lumbar spine mostly has a traumatic origin in middle aged patients 3). After 6 months of follow up, although her symptoms were still present, they had ameliorated in some degree. Because of her young age and parents' wishes, the patient was treated conservatively, that is, by medical and physical therapy. The left lateral contour of the vertebral body and the bridging transverse processes resembled the shape of the letter 'O', and the components of bone bridge had smooth, regular contours. Computed tomography revealed articulation between left transverse processes of the third and fourth lumbar vertebrae ( Fig. An anteroposterior simple radiographs of the lumbar spine demonstrated the presence of osseous bridging between the left transverse processes of the third and fourth lumbar vertebrae with minimal scoliosis at the bridging site and simultaneous disc space narrowing at the 元-L4 level ( Fig. Lumbar motion was limited in all directions, but the findings of a neurological examination, including the straight leg-raising test (SLRT) were within normal limits. A deep, firm fullness was palpable in the paravertebral muscles in the left lumbar area, and was tender to percussion.
Her detailed medical history was unremarkable, and there was no history of back injury. She reported that the pain was aggravated by extension of the lower back and prolonged by hours of standing. The pain had gradually increased in severity over 1 year, and at presentation she was unable to sit comfortably. A 13-year-old girl was referred to our hospital due to low back pain (LBP) and stiffness in the left lower back region.
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