A spinous process fracture is a break in a part of the spinal bone. This part of the bone is located toward the back of each spinal bone.
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These fractures are caused by trauma from:
- Car, motorcycle, or pedestrian accidents
- Severe and sudden twisting or bending
- Severe blows to the back and spine
- Violence, such as a gunshot
Older adults are at higher risk. Things that may increase the chance of a spinous process fracture are:
- Having health problems that weaken bones, such as osteoporosis
- Low muscle mass
- Playing sports that involve sudden twists and turns or extreme contact
- Not wearing a seatbelt
- Being around violence
These fractures can happen at any place in the spinal column. They may cause:
- Severe pain that may be worse when moving, coughing, or breathing
- Swelling and bruising
- Numbness, tingling, or weak muscles
- Problems moving the injured part of the spine
- Loss of bladder or bowel control
Unstable fractures may cause damage to the spinal cord. This can result in temporary or permanent paralysis.
The doctor will ask about your symptoms and health history. You will also be asked how the injury happened. A physical exam will be done. It will also look for nerve damage.
Images may be taken to look at your spine. This can be done with:
Treatment will depend on how severe the injury is. It may take weeks or months to heal.
The spine may need to be supported as it heals. This can be done with:
- A back brace to keep a minor fracture in place while it heals
- Traction using rigid braces to treat severe or unstable fractures
People with a severe fracture may need surgery. Screws, rods, wires, or cages will be used to reconnect bone pieces and hold them in place.
Rehabilitation may be needed. It will include exercises to keep muscles strong and help with range of motion.
Most fractures happen due to accidents. Healthy bones and muscles may help prevent injury. This may be done through diet and exercise.
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. Ortho Info—American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=a00368. Updated September 2015. Accessed September 19, 2019.
Marek AP, Morancy JD, et al. Long-Term Functional Outcomes after Traumatic Thoracic and Lumbar Spine Fractures. Am Surg. 2018 Jan 1;84(1):20-27.
Spinal trauma—emergency management. EBSCO DynaMed website. Available at:https://www.dynamed.com/management/spinal-trauma-emergency-management. Accessed September 19, 2019.
Spinal fractures. Department of Neurology University of Florida website. Available at: http://neurosurgery.ufl.edu/patient-care/diseases-conditions/spinal-fractures. Accessed September 19, 2019.
Last reviewed September 2019 by EBSCO Medical Review Board Teresa Briedwell, PT, DPT, OCS, CSCS Last Updated: 5/6/2020