Spinous Process Fracture (Clay-Shoveler’s Fracture)

The spinous process is the bony prominence which can especially be felt at the lowest cervical level at C7. A fracture can occur in the lower cervical spine from a significant tearing away of the muscles or ligaments due to an overly extended or flexed type injury.

Symptoms

An individual can present with localized pain and tenderness. Neurologic findings are rare.

Diagnostic testing

Cervical spine films are the best initial test. Instability needs to be evaluated by flexion and extension films.

Treatments

Cervical collar for 4-6 weeks. After 4-6 weeks, an individual can resume activity gradually. Rarely are there any long-term problems with a spinous process fracture or any neurologic changes.