Limbus vertebra (LV) is a frequently underdiagnosed spinal anomaly resulting from intraosseous herniation of nucleus pulposus material during skeletal immaturity, often discovered incidentally but capable of causing chronic low back pain (LBP) and neurological symptoms. We present the case of a sedentary adult with persistent LBP and paresthesia, whose imaging revealed an anterior LV at L5/S1 with concomitant intervertebral disc degeneration. Unlike most reported cases involving athletes, this case highlights LV as a cause of symptoms in non-athletic populations. The patient achieved significant relief through conservative management with chiropractic interventions, supporting a non-surgical approach as first-line therapy. A narrative review of current literature underscores the importance of accurate diagnosis-distinguishing LV from fractures, degenerative changes, and neoplastic or infectious processes-while emphasizing conservative measures for symptom control and functional recovery. Clinicians should consider LV in the differential diagnosis of chronic LBP, regardless of patient activity level, to guide effective management and avoid unnecessary interventions.
Chu et al. (Mon,) studied this question.