RxHarun

Transverse Process Fracture

Dr. Harun Ar Rashid, MD - Arthritis, Bones, Joints Pain, Trauma, and Internal Medicine Specialist Dr. Harun Ar Rashid, MD - Arthritis, Bones, Joints Pain, Trauma, and Internal Medicine Specialist
0 Views
Rx Musculoskeletal System (A - Z)

A transverse process fracture occurs when part of the protrusion is cracked. It’s not a super common injury because a couple of different factors and forces typically need to occur in order for the transverse process to fracture, and the area is usually well-protected by muscles in the area. Transverse process fractures of the lumbar spine often are considered benign fractures related to direct trauma or psoas muscle avulsion. Treatment of these usually stable injuries is primarily administered when the patient becomes symptomatic. This injury can take anywhere from 2-6 weeks to fully heal, and it generally heals fully without the need for surgery. Normal treatment routines involve rest and pain medications, and a back brace is sometimes used to stabilize the spine and limit discomfort from movement.

Pathophysiology

  • Considered stable fractures
  • Isolated fractures do not involve lamina, pedicle, or facets
  • Often extend into multiple segments

Causes

  • Typically high energy blunt trauma from a motor vehicle accident or collision sport
  • Less commonly, falls, assault, penetrating injury, crush injury, bicycle accident
  • Isolated TP fractures due to MVC more common in children than in adults
  • Isolated TP fractures due to falls more common in adults
  • Can be seen in the setting of extreme rotation and/or side bending

Pathoanatomy

  • Transverse Process
    • Attaches to Vertebrae
    • Projects laterally from region where pedicle meets lamina
    • In the upper 6 cervical spinal levels, the Vertebral Artery passes through the transverse foramen
    • Thoracic and lumbar TPs do not have a transverse foramen

Associated Injuries

  • Cervical TP fracture
    • Brachial Plexopathy
    • Vertebral Arty Dissection
  • Thoracolumbar TP fracture
    • Abdominal injuries
    • Pediatric thoracic TP fractures has a 70% correlation with head or chest injury, 20% with abdominal[4]
    • Pediatric lumbar TP fractures correlate with chest (41%), head (30%) injuries

Differential Diagnosis

Differential Diagnosis Neck Pain

  • Fractures
    • C1
      • Jefferson Fracture
    • C2
      • Odontoid Fracture
      • Hangman’s Fracture
    • C3-C7
      • Cervical Spinous Process Fracture
      • Cervical Teardrop Fracture
      • Cervical Compression Fracture
      • Transverse Process Fracture
  • Subluxations and Dislocations
    • Atlanto Occipital Dissociation
    • Cervical Facet Dislocation
    • Atlantoaxial Instability
  • Neuropathic
    • Cervical Cord Neuropraxia
    • Cervical Radiculopathy
    • Cervical Myelopathy
  • Muscle and Tendon
    • Cervical Whiplash
    • Myofascial Neck Pain
  • Pediatric/ Congenital
    • Klippel Feil Syndrome
    • Cervical Congenital Anomalies
    • Pseudosubluxation
  • Other Etiologies
    • Cervical Disc Disease
    • Cervical Spine Stenosis
    • Cervical Vascular Injuries
    • Spear Tackler’s Spine

Differential Diagnosis Back Pain

  • Fractures
    • Compression Fracture
    • Burst Fracture
    • Chance Fracture
    • Spinous Process Fracture
    • Transverse Process Fracture
    • Rib Fracture
    • Sacral Stress Fracture
  • Neurological
    • Lumbar Radiculopathy
    • Cauda Equina Syndrome
    • Sciatica
  • Musculoskeletal
    • Mechanical Back Pain
    • Scoliosis
    • Kyphosis
    • Herniated Disc
    • Facet Joint Pain
    • Sacroilliac Joint Pain
    • Spinal Stenosis
    • Spondylolysis
    • Spondylolisthesis
    • Hyperlordosis
    • Baastrups Disease
  • Autoimmune
    • Ankylosing Spondylitis
  • Infectious
    • Spinal Epidural Abscess
    • Osteomyelitis
  • Pediatric
    • Scheuermann’s Disease

Diagnosis

  • General: Physical Exam Neck, Physical Exam Back
  • History
    • Typically report a history of blunt trauma
  • Physical Exam
    • Point tenderness at the site of fracture
    • In the cervical spine, a complete neuro exam is important

  • The axial cut of T7 demonstrating non-displaced right transverse process fracture

    • AP radiograph demonstrating right L1 transverse process fracture

Radiographs

  • Standard C spine films may be indicated
    • Sensitivity is not great
  • It may be missed on up to 11% of patients undergoing evaluation after trauma[5]

CT

  • More sensitive
  • Indicated in the setting of trauma

Management

Prognosis

  • As isolated injuries, patients have an excellent prognosis
  • One study reported 100% of patients were neurologically intact at presentation which was preserved at 19 months of follow-up [4]
  • A second study found the cervical range of motion and mean neck disability index to be normal at 27 months of follow up[6]
  • Approximately 1% report persistent TP fracture-related back pain[7]

Nonoperative

  • Standard treatment is conservative
  • Some studies event suggest no specific treatment or restrictions
  • Pain management including NSAIDs, Acetaminophen, and Opiates
  • Muscle relaxers are commonly prescribed
  • Bracing with Cervical Collar, Corset]] for comfort
    • Not intended to stabilize the spine
    • No evidence that these devices promote healing, prevent worsening of injuries

You Might Also Like This Posts:

  1. Posterior Talar Process Fracture Posterior talar process fractures and dislocation may involve the medial and lateral tubercle bony protrusion or bony edge of the posterior process of the talus. The posterior talofibular ligament attaches to the lateral tubercle and flexor hallucis longus muscle runs between these two tubercles. It is missed type of fracture it allows both side-to-side rotation […]...
  2. Shepherd Fracture and Stieda Process Fractures A Shepherd fracture refers to a fracture of the lateral tubercle of the posterior process. An elongated lateral tubercle of the posterior process of the talus is mentioned as a Stieda process, so occasionally these fractures are described as Stieda process fractures. A Cedell fracture may be a fracture of the medial tubercle of the posterior process. Fractures […]...
  3. Lateral Talar Process Fracture Lateral talar process fracture or fractures dislocations, bony protrusion of the lateral and therefore the posterior processes of the talus are uncommon usually caused by a consequence of forced dorsiflexion and inversion of the fixed pronated foot. These also are commonly referred to as snowboarder’s fractures. It is missed type of fracture it allows both side-to-side rotation and up-down movement […]...
  4. Traumatic Fracture; Stress fracture; Bone fracture Bone – broken; Fracture; Stress fracture; Bone fracture If more pressure is put on a bone than it can stand, it will split or break. A break of any size is called a fracture. If the broken bone punctures the skin, it is called an open fracture (compound fracture). A stress fracture is a hairline […]...
  5. Broken nose; Nasal fracture; Nasal bone fracture A nose fracture is a break in the bone or cartilage over the bridge, or in the sidewall or septum (the structure that divides the nostrils) of the nose. Considerations A fractured nose is the most common fracture of the face. It most often occurs after an injury and often occurs with other fractures of the face. […]...
  6. Wrist Fracture – Causes, Symptoms, Diagnosis, Treatment A wrist fracture or Distal Radius Fracture is a medical term used to denote a broken wrist. The human wrist comprises 8 small bones which are together joined with the two bones of the forearm, the ulna, and radius. A breakage or crack in any of these ten bones is referred to as a wrist […]...
  7. Fracture Complications – Causes, Symptoms Fracture Complications/Fracture of Bones is a medical condition in which there is a partial or complete break in the continuity of the bone. In more severe cases, the bone may be broken into several pieces.[rx] A bone fracture may be the result of high force impact or stress, or a minimal trauma injury as a result of certain medical conditions that […]...
  8. Shoulder Fracture: Causes, Symptoms And Treatment The shoulder joint attaches the arms to the body and comprises of three main bones- Scapula or the shoulder blade, Clavicle or the collar bone and the Humerus which is the upper part of the arm bone. Several ligaments, tissues, nerves, muscles, tendons and tissues connect these bones as well as enabling their movement. These […]...
  9. Treatment For Rib Stress Fracture Fractures may result either from trauma or from stress. Traumatic fractures result from a single instance of injury or trauma which results in a fractured bone; stress fractures, on the other hand, stem from continued excessive stress over an extended period of time and are more in the nature of ‘overuse injuries.’ Stress fractures cannot […]...
  10. Distal Radioulnar Joint Dislocation Distal radioulnar joint dislocation is more commonly displaced dorsally (i.e. the distal ulna is dorsally dislocated with respect to the distal radius) but can be vulgarly displaced. If more than 50% of the articular surfaces do not articulate, then the term DRUJ subluxation is used. Distal Radioulnar Joint Instability occurs when articular contact between the two forearm […]...

To Get Daily Health Newsletter

We don’t spam! Read our privacy policy for more info.

Terms and Conditions of Use
Privacy Policy
Cookie Policy
Editorial Policy
Advertising Policy
EU User Consent Policy
Correction Policy
Citation Policy
Ethics and Logical Policies
About Us
Contact Us
Newsletter
Career
Sitemap
Advertise with us
Editorial Board Members
Review Board Member
Team RxHarun
Web Developers Team
Guest Posts and Sponsored Posts
Request for Board Member
Women Writers
Download Mobile Apps
Follow us on Social Media
© 2012 - 2025; All rights reserved by authors. Powered by Mediarx International LTD, a subsidiary company of Rx Foundation.
RxHarun
Logo