Cervical spinous process fracture: Difference between revisions
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==Background== | ==Background== | ||
*Isolated fracture of the spinous processes of the lower cervical or upper thoracic vertebrae | *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" | *Also known as "clay shoveler's fracture" | ||
*A [[Unstable spine fractures|"stable"]] fracture | *A [[Unstable spine fractures|"stable"]] fracture | ||
*C7 is most commonly affected | *C7 is most commonly affected | ||
{{Vertebral fractures and dislocations types}} | |||
==Clinical Features== | ==Clinical Features== | ||
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==Differential Diagnosis== | ==Differential Diagnosis== | ||
{{ | {{Blunt neck trauma DDX}} | ||
==Evaluation== | ==Evaluation== | ||
*Plain films or CT (preferred to eval for other injuries) of cervical/thoracic spine | *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]] | ||
Latest revision as of 13:18, 24 October 2020
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
Vertebral fractures and dislocations types
- Cervical fractures and dislocations
- Thoracic and lumbar fractures and dislocations
Clinical Features
- Pain in lower neck/upper back
- Tenderness over fracture site
Differential Diagnosis
Neck Trauma
- Penetrating neck trauma
- Blunt neck trauma
- Cervical injury
- Neurogenic shock
- Spinal cord injury
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
- Prehospital Immobilization see NAEMSP National Guidelines for Spinal Immobilization
- Place in cervical collar - high rates of union with conservative management
Disposition
- Discharge