Cervical spinous process fracture

Background

• Also known as "Clay shoveler's" fracture
• Stable

Clinical Features

• C7>C6>T1 avulsion fracture; ; caused by extreme muscle flexion where spinous process is ‘pulled off’
• Isolated fracture of the spinous processes of the lower cervical vertebrae

Differential Diagnosis

Vertebral fractures and dislocations types

Vertebral anatomy.

Numbering order of vertebrae.

• Cervical fractures and dislocations
  • Atlanto-occipital dissociation
  • C1
    • Jefferson fracture
    • C1 isolated anterior arch fracture
    • C1 isolated posterior arch fracture
  • C2
    • Odontoid fracture
    • Hangman's fracture
  • C3-C7
    • Cervical burst fracture
    • Cervical spinous process fracture
    • Extension cervical teardrop fracture
    • Flexion cervical teardrop fracture
    • Anterior cervical wedge fracture
  • Cervical facet dislocation
  • Isolated transverse process fracture
• Thoracic and lumbar fractures and dislocations
  • Chance fracture
  • Thoracic burst fracture
  • Lumbar burst fracture
  • Isolated transverse process fracture
  • Thoracic and lumbar compression fractures

Workup

• rule out lamina and facet fracture, rule out jumped facet

Management

• Prehospital Immobilization see NAEMSP National Guidelines for Spinal Immobilization
• Non-operative
  • Collar for 10 days with ortho follow up

Disposition

• Outpatient

See Also

• Cervical spine injuries