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.
Severe pain that may be worse during movement, coughing, or breathing
Tenderness, swelling, and possible bruising
Numbness, tingling, or muscle weakness
Decreased range of motion around the affected area of the spine
Loss of bladder or bowel control (injuries to lower spine)
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:
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.
Treatment will depend on:
The severity of the fracture
Location of the fracture on the spinal column
Number of fractures
Which part of the spinous process bone is broken
Treatment options for spinous process fractures may include:
Back brace—Minor or stable fractures can be treated with a back brace to keep the back in line while it heals.
Traction—Rigid braces, some with collars, are worn to treat more severe or unstable fractures. Traction allows for minimal movement.
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 remove any damaged vertebral discs.
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.
Fractures of the thoracic and lumbar spine. Ortho Info—American Academy of Orthopaedic Surgeons website. Available at: ...(Click grey area to select URL) Updated September 2015. Accessed August 30, 2017.