Cervical spinous process fracture

Background

• Also known as "Clay shoveler's" fracture
• A cervical spinous process 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

Cervical Spine 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

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

Authors

Ross Donaldson, Daniel Ostermayer