The bones that make up the spine are called vertebrae. Each vertebra has a bony section that points out toward the back. These sections are called the spinal process. Muscles and ligaments of the back attach to them to help provide movement and flexibility. These fractures can occur anywhere along the spinal column. They are more common in the vertebrae of the back and not the neck.
A spinous process fracture is a break in one or more of these sections. Most will heal without long-term damage. More severe spinous process fractures, called unstable fractures can result in spinal cord or nerve injury.
Cross Section of Spine
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Spinous process fractures are caused by severe trauma to the back such as:
Spinous process fractures more common in older adults. Other factors that may increase your chance of a spinous process fracture includes:
Activities or accidents often linked to these fractures include:
Spinal process fractures may cause:
Unstable fractures may cause damage to the spinal cord. Spinal cord damage can result in temporary or permanent paralysis. Extent or location of paralysis depends on where along the spinal column the injury occurred.
You will be asked about your symptoms and medical history as well as any accident or activity associated with the pain. A physical exam will be done. A complete neurological exam will also be done to look for signs of nerve damage.
Imaging tests to evaluate your spine may be done with:
Getting care right away is important for any spinal injury. Proper treatment can prevent or decrease long-term complications. Treatment will depend on how serious the fracture is.
Treatment and rehabilitation may take months or years, depending on whether or not there is spinal cord or nerve damage.
When there is a possibility of an unstable spinous fracture, immediate and complete immobilization of the spine is necessary.
Once immobilized, you will be assessed for any other problems, such as secondary injuries, shock, or airway obstruction. Stabilizing your injury may include:
People with unstable fractures usually need to stay in the hospital. Serious injuries may need to be watched in an intensive care unit. Some people with spinal cord damage closer to the neck may need to have help breathing with mechanical ventilation.
After you are stabilized and assessed, your course of treatment will depend on:
Treatment options for spinous process fractures may include:
It may take several weeks to several months for a spinous process fracture to heal. Healing time varies by age and your overall health. Children and people in better overall health heal faster.
Physical therapy may be advised to keep muscles strong and maintain range of motion. Long-term rehabilitation may be needed with more severe injuries.
Spinous process fractures can sometimes result in spinal cord and nerve injury, and paralysis. This may require major life changes, involving work, family, and social life. Extensive rehabilitation may be required, including occupational therapy, psychotherapy, and support groups.
To help reduce your chance of a spinous process fracture:
To help reduce falling hazards at work and home, take these steps:
National Institute of Neurological Disorders and Stroke
Ortho Info—American Academy of Orthopaedic Surgeons
Canadian Orthopaedic Foundation
Spinal Cord Injury Canada
Fractures of the thoracic and lumbar spine. American Academy of Orthopaedic Surgeons Ortho Info website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=a00368. Updated February 2010. Accessed November 12, 2013.
Spinal cord injury—acute management. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated December 10, 2013. Accessed November 12, 2013.
Spinal cord injury—chronic management. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated October 22, 2013. Accessed November 12, 2013.
Spinal fractures. Department of Neurology University of Florida website. Available at: http://neurosurgery.ufl.edu/patient-care/diseases-conditions/spinal-fractures. Accessed November 12, 2013.
Last reviewed August 2014 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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