Posterior Ring Apophyseal Fracture (PRAF) in a 13-Year-Old Adolescent Girl Treated With Unilateral Biportal Endoscopy: A Case Report.

Posterior ring apophyseal fracture (PRAF) is a rare but significant cause of lower back pain and radiculopathy in adolescents, commonly occurring due to trauma or intense physical activity. This is a case report of a 13-year-old girl with PRAF associated with lumbar disc herniation (LDH) following a sports injury, emphasizing diagnostic challenges and surgical management. The patient underwent unilateral laminectomy for bilateral decompression through unilateral biportal endoscopy (UBE-ULBD) at the L4-L5 level. Postoperatively, the patient had significant clinical improvement in the visual analog scale (VAS) score for leg and back pain at one-month follow-up. Although rare, PRAF associated with LDH is an important differential diagnosis for post-traumatic lower back pain in adolescents. Accurate preoperative imaging and minimally invasive surgical techniques such as UBE-ULBD provide effective decompression and improved clinical outcomes, allowing for a quicker return to daily activities.