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Definition

The bones of spinal column are called vertebrae. Each vertebra has two wing-like protrusions, called a transverse process, that extend toward the sides. These protrusions provide an area for muscles and ligaments to attach to provide movement and flexibility in the back. Transverse process fractures can occur anywhere along the spinal column. They are more common in the back than the neck.

A transverse process fracture is a break or crack in one or more of these protrusions.

Cross Section of Spine

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Causes

Transverse process fractures are caused by severe trauma to the back such as:

  • Falls
  • Car, motorcycle, or pedestrian collisions
  • Severe and sudden twisting or bending
  • Severe blows to the back and spine
  • Violence, such as a gunshot
Risk Factors

Certain factors may increase your risk of fractures including:

  • Advancing age
  • Osteoporosis
  • Certain diseases or conditions that weaken bones, such as tumors or cysts
  • Decreased muscle mass

Activities or accidents most often associated with transverse process fractures include:

  • Falls from heights, such as a ladder, bike, or horse
  • Playing certain sports that involve sudden twists and turns, or extreme contact especially without proper protective gear
  • Car or motorcycle accidents especially without use of seatbelt
  • Severe and sudden twisting or bending
  • Severe blows to the back and spine
  • Violence, such as a gunshot
Symptoms

Transverse process fractures may cause:

  • Severe pain that may be worse during movement
  • Tenderness, swelling, and possible bruising over the area
  • Numbness, tingling, or muscle weakness
  • Decreased range of motion around the affected area of the spine
  • Loss of bladder or bowel function
Diagnosis

You will be asked about your symptoms and medical history as well as any accident or activity associated with the pain. . The injured area will be examined. A complete neurological exam will be done to look for damage to the nerves.

Imaging tests may be done to look for signs of damage to the bones and effects on the spinal cord. Tests may include:

Treatment

Immediate care is important. Proper treatment can prevent long-term problems. Treatment will depend on how serious the fracture is.

Bone Support

Some fractures cause pieces of bones to separate. These pieces will need to be put back into their proper place. This may be done:

  • Without surgery—Minor injuries can be treated with a back brace to keep your spinal column in line while it heals.
  • Surgery—Screws, rods, wires, or cages are used to reconnect bone pieces and hold them in place. Surgery may also be needed to repair vertebrae, relieve pressure on the spinal cord or nerves, or remove any damaged discs.
Rest and Recovery

It may take up to six weeks for a transverse spinal fracture to heal. Healing time varies by age and your overall health. Children and people in better overall health heal faster.

You will need to adjust your activities while your spine heals, but complete rest is rarely required and can actually slow recovery.

As you recover, you may be referred to physical therapy or rehabilitation to start range-of-motion and strengthening exercises. Do not return to activities or sports until your doctor says it is okay to do so.

Prevention

Fractures are most often the result of an accident. To decrease the risk or severity of accidents:

  • Avoid situations that put you at risk of physical harm.
  • Always wear a seatbelt when driving or riding in a car.
  • Do not drive under the influence of alcohol or drugs.
  • Wear proper padding and safety equipment for sports and activities.
  • Do weight-bearing exercises to build strong muscles and bones.

To help reduce falling hazards at work and home, take these steps:

  • Clean spills and slippery areas right away
  • Remove tripping hazards such as loose cords, rugs, and clutter
  • Use non-slip mats in the bathtub and shower
  • Install grab bars next to the toilet and in the shower or tub
  • Put handrails on both sides of stairways
  • Walk only in well-lit rooms, stairs, and halls
  • Keep flashlights on hand in case of a power outage

RESOURCES:

American Academy of Orthopaedic Surgeons
http://orthoinfo.org

National Institute of Neurological Disorders and Stroke
http://www.ninds.nih.gov

CANADIAN RESOURCES:

Canadian Orthopaedic Foundation
http://www.canorth.org

Spinal Cord Injury Canada
http://sci-can.ca

References:

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 6, 2013.

Krueger MA, Green DA, et al. Overlooked spine injuries associated with lumbar transverse process fractures. Clin Orthop Related Res. 1996;327:191-195.

Seo MR, Park SY, et al. Spinous process fractures in osteoporotic thoracolumbar vertebral fractures. Br J Radiol. 2011;84(1007):1046-1049.

Spinal cord injury-acute management. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us. Updated January 23, 2013. Accessed November 6, 2013.

Transverse process fracture. Sports Injury Clinic website. Available at: http://www.sportsinjuryclinic.net/sport-injuries/low-back-pain/transverse-process-fracture. Accessed November 6, 2013.



Last reviewed November 2013 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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