Cervical spinous process fracture: Difference between revisions

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==Background==
==Background==
*Also known as "Clay shoveler's" fracture
*Isolated fracture of the spinous processes of the lower cervical or upper thoracic vertebrae
*A cervical spinous process fracture
*Caused by hyperflexion of neck → muscles pull on supraspinous ligament → avulsion fracture of spinous process
*Stable
*Also known as "clay shoveler's fracture"
*A [[Unstable spine fractures|"stable"]] fracture
*C7 is most commonly affected


==Clinical Features==
==Clinical Features==
*C7>C6>T1 avulsion fx; ; caused by extreme muscle flexion where spinous process is ‘pulled off’
*Pain in lower neck/upper back
*Isolated fracture of the spinous processes of the lower cervical vertebrae
*Tenderness over fracture site


==Differential Diagnosis==
==Differential Diagnosis==
{{Cervical spine injuries}}
{{Cervical spine injuries}}


==Workup==
==Evaluation==
*r/o lamina and facet fx, r/o jumped facet
*Plain films or CT (preferred to eval for other injuries) of cervical/thoracic spine
*[[Neurologic exam]] (fracture only rarely associated with neurologic injury)


==Management==
==Management==
*Prehospital Immobilization see [[EBQ:Prehospital Spine Immobilization|NAEMSP National Guidelines for Spinal Immobilization]]
*Prehospital Immobilization see [[EBQ:Prehospital Spine Immobilization|NAEMSP National Guidelines for Spinal Immobilization]]
*Non-operative
*Place in cervical collar - high rates of union with conservative management
**Collar for 10 days with ortho f/u


==Disposition==
==Disposition==
*Outpatient
*Discharge


==See Also==
==See Also==
*[[Cervical spine injuries]]
*[[Cervical spine injuries]]
==References==
<references/>


[[Category:Trauma]]
[[Category:Trauma]]
[[Category:Ortho]]
[[Category:Orthopedics]]

Revision as of 02:45, 9 June 2018

Background

  • Isolated fracture of the spinous processes of the lower cervical or upper thoracic vertebrae
  • Caused by hyperflexion of neck → muscles pull on supraspinous ligament → avulsion fracture of spinous process
  • Also known as "clay shoveler's fracture"
  • A "stable" fracture
  • C7 is most commonly affected

Clinical Features

  • Pain in lower neck/upper back
  • Tenderness over fracture site

Differential Diagnosis

Vertebral fractures and dislocations types

Vertebral anatomy.
Numbering order of vertebrae.

Evaluation

  • Plain films or CT (preferred to eval for other injuries) of cervical/thoracic spine
  • Neurologic exam (fracture only rarely associated with neurologic injury)

Management

Disposition

  • Discharge

See Also

References