Cervical spinous process fracture

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

Cervical Spine Fracture and Dislocation Types

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

See Also

Cervical spine injuries

References

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