Fractures of the spinous process fractures are usually benign injuries. Clay shoveler’s fracture is thought to occur from powerful contraction of the muscles that insert onto the spinous process.
Otherwise also the spinous process fractures can be present with lamina fractures, facet dislocations, and various other injuries to the cervical spine.
Clay shoveler’s fracture is type of hyperflexion avulsion injury that causes fractures of spinous process at base. Most commonly they occur at C7 level followed by C6 and T1.
Per se isolated spinous process fractures are considered stable injuries. But if avulsion extends into lamina, the injury becomes serious in nature.
Diagnosis
Plain radiographs are good enough to diagnose. However if associated injury and neurological loss is suspected, an MRI should be done.
Treatment:
Stable fractures can be managed by symptomatic treatment and cervical collar which should be worn until good callus is present.
If unstable, the injury needs evaluation and treatment would depend upon the associated injuries.
Image Credit: http://faculty.washington.edu/alexbert/MEDEX/Winter/EM1DisordersSpine.htm
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Dear Dr Arun,
Following your post about C7 Spinous Process Avulsion Fracture Or Clay Shoveler’s Fractures, I would care to ask you what implications could there be should the said fracture have happened three years ago.
Thank you very much for you help.
Best regards,
Andre Censi
Dr Arun Pal Singh Reply:
November 14th, 2010 at 7:38 am
@Andre Censi,
What problems do you have? How were you treated?
i’m 31 years old. About five years back i had a C7th spinous process fracture while i was playing cricket. i just felt a little pain around that area while a sudden extension of the head. few hours back it was so severe that i could not even to wear a shirt.
Xray cervical region cleared that fracture. no surgical intervention done.
now i am ok. but time to time i started feeling severe pain preceded by neck movements in the morning. once it happened it exists several days with extreme pain, difficult to sleep even.
I’m also having bilateral cervical ribs. what should i do?
i can post my Xray even.
Dr Arun Pal Singh Reply:
December 29th, 2010 at 12:29 pm
@Eranda Janaka,
Did you see a doctor recently.
is it just c6,7,t1 affected wt of c5
Dr Arun Pal Singh Reply:
March 31st, 2011 at 10:10 am
@anita godfey,
Sorry! I did not get you. Could you please elaborate.
Hi,
I have been trying to find more information regarding this injury and its treatment. I am 43 yr old male. I suffered C7 clay shovellers fracture from weight-lifting. I was squatting appox 280lbs and the weight bar broke of the C7 spinous process. Was diagnosed correctly with X-ray and Cat scan. Fracture was stable and no surgery required. Did a little rehab and therapy at the time and had no serious lingering effects.
Now 2.5 years later I am experiencing many problems. in the mid/upper back area on a daily basis. Have revisited family doctor to no avail. Have tried chiropractic, massage, and laser therapy. Even though these therapies do relieve pain, it is usually short-lived.
I was just wondering if there can be serious problems with the regionalized muscles as they attempt to re anchor to the spine? This spinous process is a major muscle attachment and I am thinking this may be the source of all my back pain. Can anyone enlighten me or point me in a direction that would help me understand the after effects better? Thanks in advance!
Dr Arun Pal Singh Reply:
January 11th, 2012 at 4:50 pm
@Jeff Bethune,
You need to consult a specialist and get investigated if required.
Your source of pain may be what you mentioned or it might be something else.
You need to get examined to find out that.
I hope that helps.