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Spinous Process Fracture of Cervical Vertebral Body

Piran Aliabadi, MD
B Leonard Holman, MD

November 8, 1995

Presentation

A 40-year-old man presented with lower neck pain after abrupt flexion of the head during intense manual work. Physical examination and neurologic findings were normal except for tenderness in the posterior aspect of the lower neck. The patient was not wearing a cervical collar.

Imaging Findings

Plain Radiograph of the Cervical Spine

A complete cervical spine radiograph series, including lateral views with flexion and extension, was obtained. The lateral view above shows an avulsion fracture of the spinous process of the C7 vertebra (black arrow). Degenerative changes of the C5-C7 disc spaces are also visible (white arrows).

Diagnosis

The patient was treated for an avulsion fracture of the C7 spinous process.

Discussion

An avulsion fracture of the spinous process of the lower cervical vertebra and T1 (C7, C6 and T1, in order of frequency) is called a "clay shoveler's fracture". It is due to abrupt flexion against the tense posterior ligaments of the neck. This is a stable fracture. The diagnosis is made on plain radiographs; no other imaging is needed for evaluation of this fracture.

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