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Cross Section of Spine  
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Definition  

The bones that make up the spine are called vertebrae. Each vertebra has a boney 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.

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Causes  

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

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

Spinal process fractures may cause:

  • 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.

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Diagnosis  

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.

Images may be taken of your bodily structures. This may be done with:

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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.

Once immobilized, you will be assessed for any other problems, such as secondary injuries, shock, or airway obstruction. Stabilizing your injury may include:

  • 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: