Munson Health
 
Spinous Process Fracture

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Risk Factors

Spinous process fractures more more common in older adults. Certain factors may increase your risk of fractures including:
  • Osteoporosis
  • Certain diseases or conditions that weaken bones, such as tumors or cysts
  • Decreased muscle mass
Activities or accidents often linked to these 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
 

Treatment

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.

Immobilization

When there is a possibility of an unstable spinous fracture, immediate and complete immobilization of the spine is necessary.
  • A breathing tube for a blocked airway
  • IV fluids
  • Admission to the hospital for monitoring
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.

Bone Support

After you are stabilized and assessed, your course of 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 your 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.

Rest and Recovery

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.

Long-term Rehabilitation

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.
 

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 12, 2013.


Spinal cord injury-acute management. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us. Updated January 23, 2013. Accessed November 12, 2013.


Spinal cord injury-chronic management. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us. 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.

 

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