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Spinous Process Avulsion Fracture

Case Detail

Anatomy: Brain-Spine
Junewick
Joseph Junewick, MD FACR
Diagnostic Category: Trauma
Created: over 7 years ago
Updated: over 7 years ago
Tags: PEDS
Modality/Study Types: MR CT
Activities:
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History

10 year old female restrained passenger in a motor vehicle accident with Glascow Coma Score of 15.


Case Images


Diagnosis

Spinous Process Avulsion Fracture

Clinical Notes

Clinical and radiographic injuries include: seatbelt pattern contusion, right clavicle fracture, left pneumothorax and pulmonary contusions, and splenic laceration.

Findings

CT – Oblique coronal fracture through spinous process of C6 with minimal separation of fragments.

MR – Fracture associated with paraspinous muscular edema.

Discussion

Spinous process avulsion fractures occur as a result of forced flexion against the opposing action of the interspinous and superspinous ligaments. This fracture has been also referred to as"clay shoveler’s fracture", “coal miner’s fracture”, “shoveler’s fracture” and “shoveler’s disease”. The injury occurs most frequently at C7, followed by C6 and then T1. The injury is limited to the spinous process; it is unusual for the fracture to extend to the lamina. The fracture line is oblique, perpendicular to the orientation of the interspinous ligament.

Reference

Harris JH and Mirvis SE. The Radiology of Acute Cervical Spine Trauma, 3rd Ed. 1996.



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