Fracture of the spinous processes; a new sign for the recognition of fractures of cervical and upper dorsal spinous processes.

Abstract

Spinous process fractures are most readily seen on the lateral view. On the anteroposterior view they are recognized only with difficulty, unless especially sought. The radiographic diagnosis of fractures of the spinous processes of the seventh cervical and the first thoracic vertebra can be made on the preliminary anteroposterior view of the cervical and upper thoracic spine. The fracture can be identified by the malalignment and downward displacement of the outer end of the spinous process. On the x-ray film, a double shadow is seen. A smooth, crescentic area of decreased density represents the fractured base of the spinous process, and a denser shadow lying in the soft tissues, slightly caudad to the base of the spinous process, represents the displaced tip. Patients who have received a severe head or neck injury usually report to the hospital with the head held either in hyperflexion or hyperextension. On the routine lateral view of the neck it is difficult to see the spinous processes of C-7 and T-l ...